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General NPI Number Information
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NPI Number | 1942465521
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Entity Type | Organization
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Legal Business Name | MEHTA & MEHTA PHYSICIANS PC
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 36 OSPREY AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-7303
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Country | US
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Telephone | 631-727-4171
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Fax | 631-727-3660
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Provider Business Mailing Address
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Address Line | 41 BAY AVE
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City | EAST MORICHES
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State | NY
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Zip | 11940-1209
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Country | US
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Telephone | 631-878-1543
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Fax | 631-878-5587
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Authorized Official
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Title or Position | PATNER
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Name | DR. RANJANA D MEHTA
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Credential | MD
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Telephone | 631-878-1543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 170734
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 197342
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 198176
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License Number State | NY
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