Provider Demographics
NPI:1477664399
Name:BHARAT K MEHTA MD PC
Entity Type:Organization
Organization Name:BHARAT K MEHTA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:K
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-253-5257
Mailing Address - Street 1:2632 NAZARETH RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2715
Mailing Address - Country:US
Mailing Address - Phone:610-253-5257
Mailing Address - Fax:610-253-2336
Practice Address - Street 1:2632 NAZARETH RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-2715
Practice Address - Country:US
Practice Address - Phone:610-253-5257
Practice Address - Fax:610-253-2336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029443E207R00000X
NJ25MA04623500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
110227327OtherRAILROAD MEDICARE
PA2026982000OtherINDEPENDENCE BLUESHIED
NJ2206307Medicaid
P2091522OtherOXFORD
PA0015368290002Medicaid
NY01429794Medicaid
01330668OtherHIGHMARK BLUE SHIELD
P003072OtherGATEWAY
01007201OtherCAPITAL BLUE CROSS
93037OtherAETNA HMO
PA=========OtherUNITED HEALTHCARE
PA=========OtherCIGNA
01007201OtherCAPITAL BLUE CROSS
PA=========OtherUNITED HEALTHCARE
PA2026982000OtherINDEPENDENCE BLUESHIED
PA0015368290002Medicaid
B96810Medicare UPIN