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General NPI Number Information
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NPI Number | 1255743365
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Entity Type | Individual
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Provider Name | SHILPA MEHTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2014
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 1 BROOKDALE PLZ
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City | BROOKLYN
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State | NY
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Zip | 11212-3139
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Country | US
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Telephone | 718-240-5893
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Fax |
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Provider Business Mailing Address
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Address Line | 1 ELM ST APT 5-B
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City | TUCKAHOE
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State | NY
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Zip | 10707-3919
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Country | US
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Telephone | 917-715-9115
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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 | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 292856-1
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License Number State | NY
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