OrganizationActive
Basant K. Mittal, M.D. P.C.
NPI 1992828396 · Primary Care Clinic/Center · Shamokin Dam, PA
Provider details
- NPI number
- 1992828396
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Basant Mittal, President
- License
- MD-039080-L (PA)
Practice location
3032 N. Susquehanna Trail
Routes 11 and 15
Shamokin Dam, PA 17876-0429
Phone: (570) 743-5020
Fax: (570) 743-4505
Mailing address
Po Box 429
Shamokin Dam, PA 17876-0429
Registry dates
- Enumerated
- 2007-04-09
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.