Provider Demographics
NPI:1083891386
Name:SATISH R MEHTA MD PA
Entity Type:Organization
Organization Name:SATISH R MEHTA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:ABION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-350-6411
Mailing Address - Street 1:40 DARTMOOR RD
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3912
Mailing Address - Country:US
Mailing Address - Phone:973-273-1515
Mailing Address - Fax:973-230-0883
Practice Address - Street 1:194 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07108-2809
Practice Address - Country:US
Practice Address - Phone:973-273-1515
Practice Address - Fax:973-230-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA38291207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3275001Medicaid
NJ3275001Medicaid