MEDICARE: LEENA MEHTA .D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	140922	NY

General Provider Information

NPI Number	:	1962430975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEENA MEHTA .D., P.C.

Provider Business Mailing Address
First Line	:	790 LINDEN AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2716
Country	:	US
Telephone Number	:	585-385-9030
Fax Number	:	585-385-9124

Provider Business Practice Location Address
First Line	:	2211 LYELL AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-5743
Country	:	US
Telephone Number	:	585-429-5555
Fax Number	:	585-429-6581

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LEENA MEHTA
Credential	:	MD
Telephone Number	:	585-429-5555

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/22/2020

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