Mahadevia, Surendrakumar
Mahadevia, Surendrakumar is an individual health care provider with primary practice located at 9028 Van Wyck Expy , Jamaica NY 11418-2898. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Mahadevia, Surendrakumar can be contacted via phone (718) 206-5300.Contact Information
Primary practice address
9028 Van Wyck Expy
Jamaica NY 11418-2898
Phone: (718) 206-5300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 111411 | New York |
Profile Details
| NPI number | 1326107301 |
|---|---|
| LBN Legal business name | Mahadevia, Surendrakumar |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 6th, 2006 |
| Last updated | Mar 13th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326107301 | NPPES |
| New York | MEDICAID | 00200308 |
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