Provider Demographics
NPI:1720097850
Name:MOHAN, NIRAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:
Last Name:MOHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 NORTHERN PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2141
Mailing Address - Country:US
Mailing Address - Phone:412-457-0060
Mailing Address - Fax:412-457-0067
Practice Address - Street 1:2570 HAYMAKER RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-7618
Practice Address - Fax:412-858-7628
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063044L207R00000X, 208M00000X
WV25362207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00395014OtherRAILROAD MEDICARE
PA0016931230001Medicaid
G72214Medicare UPIN
PA0016931230001Medicaid
PA010889Medicare ID - Type Unspecified