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General NPI Number Information
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NPI Number | 1174787956
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Entity Type | Individual
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Provider Name | TEJAL MEHTA
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Gender | Female
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 12/17/2020
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Provider Practice Location Address
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Address Line | 105 RAIDER BLVD STE 101
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-1528
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Country | US
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Telephone | 908-281-0221
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Fax |
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Provider Business Mailing Address
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Address Line | 901 MCCLINTOCK DR SUITE 202
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City | BURR RIDGE
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State | IL
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Zip | 60527-0871
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Country | US
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Telephone | 888-220-6432
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 4301085728
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 25MA10956500
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License Number State | NJ
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