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General NPI Number Information
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NPI Number | 1528593621
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Entity Type | Individual
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Provider Name | MR. DEEPAK B MEHTA
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Gender | Male
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 2 PARK AVE
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City | YONKERS
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State | NY
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Zip | 10703-3402
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Country | US
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Telephone | 908-342-0662
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 623
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City | MARTINSVILLE
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State | NJ
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Zip | 08836-0623
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Country | US
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Telephone | 908-342-0662
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 043578
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP439907
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI02993100
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License Number State | NJ
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