Healthcare Provider Details

I. General information

NPI: 1487397717
Provider Name (Legal Business Name): NIKITA SAURABH MEHTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

2 LEGENDS BLVD
WEST NYACK NY
10994-2447
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-3000
  • Fax:
Mailing address:
  • Phone: 845-536-3324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number333175
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: