Provider Demographics
NPI:1982281333
Name:MOTA, JAVIER FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:FRANCISCO
Last Name:MOTA
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 1:3128 HENRY HUDSON PKWY APT 506
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3297
Mailing Address - Country:US
Mailing Address - Phone:347-668-6632
Mailing Address - Fax:
Practice Address - Street 1:1983 MARCUS AVE STE 130
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2004
Practice Address - Country:US
Practice Address - Phone:516-802-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY3312982080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program