Provider Demographics
NPI:1861609950
Name:MUKERJI, NEIL (MD, FAPA)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:MUKERJI
Suffix:
Gender:M
Credentials:MD, FAPA
Other - Prefix:DR
Other - First Name:INDRONEIL
Other - Middle Name:
Other - Last Name:MUKERJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, FAPA
Mailing Address - Street 1:4237 S PIPKIN RD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-1442
Mailing Address - Country:US
Mailing Address - Phone:863-701-2470
Mailing Address - Fax:
Practice Address - Street 1:4237 S PIPKIN RD BLDG 2
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-1442
Practice Address - Country:US
Practice Address - Phone:863-701-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1612822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry