Healthcare Provider Details

I. General information

NPI: 1548855877
Provider Name (Legal Business Name): HEYDAY HEALTH MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 02/14/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MIFFLIN PL STE 400
CAMBRIDGE MA
02138-4946
US

IV. Provider business mailing address

143 BOARDMAN CANFIELD RD STE 359
BOARDMAN OH
44512-4804
US

V. Phone/Fax

Practice location:
  • Phone: 234-200-0854
  • Fax:
Mailing address:
  • Phone: 234-200-0854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NUPUR MEHTA
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 234-200-0854