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General NPI Number Information
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NPI Number | 1013979798
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Entity Type | Individual
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Provider Name | DEEPA S MINHAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 12/12/2017
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Provider Practice Location Address
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Address Line | 12 W MAIN ST
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City | MENDHAM
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State | NJ
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Zip | 07945-1213
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Country | US
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Telephone | 973-543-1996
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Fax | 973-543-5775
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Provider Business Mailing Address
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Address Line | LB# 7550 PO BOX 95000
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City | PHILADELPHIA
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State | PA
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Zip | 19195-7550
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Country | US
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Telephone | 844-362-1735
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Fax | 973-290-7495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA052535
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License Number State | NJ
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