Healthcare Provider Details

I. General information

NPI: 1700865037
Provider Name (Legal Business Name): SWATI A. MEHTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: DR. SWATI A. MEHTA

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KINGS COUNTY HOSPITAL CENTER - PEDIATICS DEPARTMENT 451 CLARKSON AVE
BROOKLYN NY
11203
US

IV. Provider business mailing address

161 ROSE LN
NEW HYDE PARK NY
11040-1656
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-3660
  • Fax: 718-245-3729
Mailing address:
  • Phone: 718-245-3632
  • Fax: 718-245-3729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number163781
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: