Provider Demographics
NPI:1487228417
Name:MEHTA, ISHANI (MBBS)
Entity Type:Individual
Prefix:MS
First Name:ISHANI
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 WISCONSIN AVE NW
Mailing Address - Street 2:4TH FLOOR, DEPARTMENT OF PEDIATRICS
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-243-3400
Mailing Address - Fax:202-243-3234
Practice Address - Street 1:4200 WISCONSIN AVE NW
Practice Address - Street 2:4TH FLOOR, DEPARTMENT OF PEDIATRICS
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-243-3400
Practice Address - Fax:202-243-3234
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program