Healthcare Provider Details

I. General information

NPI: 1982861118
Provider Name (Legal Business Name): MISS SEJAL D MEHTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7TH AND CLAYTON STREETS 2ND FLOOR
WILMINGTON DE
19805
US

IV. Provider business mailing address

40 NEWPORT PARKWAY APT #606
JERSEY CITY NJ
07310
US

V. Phone/Fax

Practice location:
  • Phone: 302-575-8041
  • Fax: 302-575-8050
Mailing address:
  • Phone: 201-680-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: