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General NPI Number Information
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NPI Number | 1134438138
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Entity Type | Individual
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Provider Name | PRITI MEHTA GOR M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2010
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 8701 DARROW RD
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City | TWINSBURG
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State | OH
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Zip | 44087-2105
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Country | US
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Telephone | 216-407-2402
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Fax |
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Provider Business Mailing Address
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Address Line | 6729 PIN TAIL DR
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City | BRECKSVILLE
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State | OH
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Zip | 44141-2845
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Country | US
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Telephone | 216-225-3400
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.099445
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License Number State | OH
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