Provider Demographics
NPI:1376856013
Name:MEHTA, ILA NIKHIL (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ILA
Middle Name:NIKHIL
Last Name:MEHTA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CENTRAL SQUARE PARK
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1873
Mailing Address - Country:US
Mailing Address - Phone:732-744-1751
Mailing Address - Fax:
Practice Address - Street 1:50 LAWRENCE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3121
Practice Address - Country:US
Practice Address - Phone:908-931-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02831500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist