| Organization Name: | BASANT K. MITTAL, M.D. P.C. |
| NPI Number: | 1992828396 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BASANT KUMAR MITTAL (PRESIDENT) |
| Mailing Address: | 3032 N. Susquehanna Trail Routes 11 And 15 Shamokin Dam |
| State: | PA US |
| Postal Code: | 178760429 |
| Phone Number: | 5707435020 |
| Fax Number: | 5707434505 |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MD-039080-L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |