Provider Demographics
NPI:1093338808
Name:MEHTA, ROOTVIK D (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROOTVIK
Middle Name:D
Last Name:MEHTA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 EARLIN AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-1768
Mailing Address - Country:US
Mailing Address - Phone:609-726-5800
Mailing Address - Fax:
Practice Address - Street 1:6 EARLIN AVE STE 130
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015-1768
Practice Address - Country:US
Practice Address - Phone:609-726-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI0850600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist