Healthcare Provider Details

I. General information

NPI: 1366351934
Provider Name (Legal Business Name): AKSHAT MEHTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

1 NASHUA ST APT 2905
BOSTON MA
02114-1646
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-3023
  • Fax:
Mailing address:
  • Phone: 732-770-9312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL26537
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: