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General NPI Number Information
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NPI Number | 1669051082
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Entity Type | Individual
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Provider Name | RAJA NAYAN MEHTA DO
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Gender | Male
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Dates
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Enumeration Date | 04/04/2021
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | E 6 45TH ST 9TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 347-558-4094
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Fax |
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Provider Business Mailing Address
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Address Line | 24 DANTON LN N
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City | LOCUST VALLEY
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State | NY
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Zip | 11560-1122
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Country | US
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Telephone | 516-547-6765
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 328936
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License Number State | NY
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