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General NPI Number Information
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NPI Number | 1225325095
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Entity Type | Individual
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Provider Name | RAHUL MEHTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 230 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1121
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Country | US
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Telephone | 215-762-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 593 CRANBURY RD STE 1A
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4093
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Country | US
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Telephone | 732-613-8880
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Fax | 732-613-8880
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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 | MD452845
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 25MA10375900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD452845
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License Number State | PA
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