Provider Demographics
NPI:1154338747
Name:STEVEN MEHL, D.P.M., P.C.
Entity type:Organization
Organization Name:STEVEN MEHL, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-326-7771
Mailing Address - Street 1:6508 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2423
Mailing Address - Country:US
Mailing Address - Phone:718-326-7771
Mailing Address - Fax:718-326-7778
Practice Address - Street 1:6508 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-2423
Practice Address - Country:US
Practice Address - Phone:718-326-7771
Practice Address - Fax:718-326-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003266213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00711160Medicaid
NY00711160Medicaid
NY89369Medicare ID - Type Unspecified
NY0686920002Medicare NSC