Provider Demographics
NPI:1144553512
Name:MEHTA, FRENNY R (DPT)
Entity type:Individual
Prefix:MISS
First Name:FRENNY
Middle Name:R
Last Name:MEHTA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 OLD COUNTRY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4938
Mailing Address - Country:US
Mailing Address - Phone:516-935-1958
Mailing Address - Fax:516-827-0713
Practice Address - Street 1:651 OLD COUNTRY RD
Practice Address - Street 2:STE 100
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4938
Practice Address - Country:US
Practice Address - Phone:516-935-1958
Practice Address - Fax:516-827-0713
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031886174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist