Provider Demographics
NPI:1043343429
Name:MEHTA, ANJALI R (MD)
Entity Type:Individual
Prefix:
First Name:ANJALI
Middle Name:R
Last Name:MEHTA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:123 SUMMER ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1216
Mailing Address - Country:US
Mailing Address - Phone:508-368-3103
Mailing Address - Fax:508-368-3104
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-368-3103
Practice Address - Fax:508-368-3104
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2015-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD12698207Y00000X
MA244036207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology