| Doctor Name: | NELSON MUTHRA |
| NPI Number: | 1033574439 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A |
| License Number: | 0044551 |
| Business Practice Address: | 354 Hunter St Ossining, NY - 105625400 |
| Business Phone Number: | 9148372558 |
| Business Fax Number: | |
| Mailing Address: | 30 Juniper Hill Rd, WHITE PLAINS |
| State: | NY |
| Postal Code: | 106072104 |
| Phone Number: | 9149410108 |
| Fax Number: | 9149413331 |
| NPI Enumeration Date: | 12/29/2015 |
| NPI Last Update Date: | 12/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0044551 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |