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General NPI Number Information
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NPI Number | 1932789542
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Entity Type | Organization
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Legal Business Name | MISSION HEALTH PA
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 20 CHERRY TREE FARM RD
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City | MIDDLETOWN
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State | NJ
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Zip | 07748-2251
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Country | US
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Telephone | 732-372-7701
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Fax | 732-243-9253
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Provider Business Mailing Address
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Address Line | 99 NEW ST APT 448
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City | METUCHEN
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State | NJ
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Zip | 08840-1978
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Country | US
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Telephone | 732-372-7701
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Fax | 732-243-9253
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Authorized Official
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Title or Position | OWNER
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Name | DR. MEENAL BHOOTADA
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Credential | PT,DPT
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Telephone | 650-619-6237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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