Healthcare Provider Details

I. General information

NPI: 1891323978
Provider Name (Legal Business Name): RICHA MEHTA THAKKAR DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 RT. 73 NORTH, UPPER LEVEL A
MARLTON NJ
08053
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-988-3444
  • Fax: 856-988-0553
Mailing address:
  • Phone: 856-988-3444
  • Fax: 856-988-0553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MB12602600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDO219520
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: