Healthcare Provider Details

I. General information

NPI: 1780754085
Provider Name (Legal Business Name): RESPACARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 UNION AVENUE
BRIDGEWATER NJ
08807
US

IV. Provider business mailing address

489 UNION AVENUE
BRIDGEWATER NJ
08807
US

V. Phone/Fax

Practice location:
  • Phone: 732-356-9950
  • Fax: 732-356-9959
Mailing address:
  • Phone: 732-356-9950
  • Fax: 732-356-9959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMA55142
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMA55142
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMA55142
License Number StateNJ

VIII. Authorized Official

Name: NEHAL LAHERI MEHTA
Title or Position: OWNER/PHYSICIAN
Credential:
Phone: 732-356-9950