Provider Demographics
NPI:1427491745
Name:ESTEFANOS, MERVAT (MD)
Entity type:Individual
Prefix:
First Name:MERVAT
Middle Name:
Last Name:ESTEFANOS
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 1:95 ORIENT WAY
Mailing Address - Street 2:APARTMENT 2C
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2143
Mailing Address - Country:US
Mailing Address - Phone:201-538-8029
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVE , ROOM M1-18
Practice Address - Street 2:METROPOLITAN HOSPITAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-423-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0695872084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry