Provider Demographics
NPI:1336731272
Name:MEZRAHI, ADINA S (NP)
Entity Type:Individual
Prefix:MRS
First Name:ADINA
Middle Name:S
Last Name:MEZRAHI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3618
Mailing Address - Country:US
Mailing Address - Phone:718-431-4080
Mailing Address - Fax:
Practice Address - Street 1:1944 E 23RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3618
Practice Address - Country:US
Practice Address - Phone:718-431-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347298363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner