Provider Demographics
NPI:1992943914
Name:MEJIA, MARIA DEL ALBA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DEL ALBA
Last Name:MEJIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:MEJIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:234 EAST 149TH STREET,
Mailing Address - Street 2:7B RM 121
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4805
Mailing Address - Country:US
Mailing Address - Phone:718-579-4820
Mailing Address - Fax:
Practice Address - Street 1:234 E 149TH ST RM 121
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-4820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2686402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014494000Medicaid
FLIC5382Medicare PIN