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General NPI Number Information
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NPI Number | 1114086691
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Entity Type | Organization
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Legal Business Name | HEMANGINI MEHTA
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 2301 E EVESHAM RD SUITE 407
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City | VOORHEES
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State | NJ
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Zip | 08043-4501
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Country | US
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Telephone | 856-772-5907
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 E EVESHAM RD SUITE 407
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City | VOORHEES
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State | NJ
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Zip | 08043-4501
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Country | US
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Telephone | 856-772-5907
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HEMANGINI MEHTA
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Credential | M.D.
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Telephone | 856-772-5907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 25MA03130400
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License Number State | NJ
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