Provider Demographics
NPI:1205895273
Name:MEHRISHI, ANSHU (MD)
Entity type:Individual
Prefix:
First Name:ANSHU
Middle Name:
Last Name:MEHRISHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25012 HILLSIDE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2139
Mailing Address - Country:US
Mailing Address - Phone:718-347-0411
Mailing Address - Fax:718-347-0455
Practice Address - Street 1:250-12B HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2139
Practice Address - Country:US
Practice Address - Phone:718-347-0411
Practice Address - Fax:718-347-0455
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252587207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02706903Medicaid
NY02706903Medicaid
NYI48089Medicare UPIN