Provider Demographics
NPI:1497804793
Name:MEHTA, DHRUTI PURNANSHU (MD)
Entity Type:Individual
Prefix:DR
First Name:DHRUTI
Middle Name:PURNANSHU
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:SUITE 2700
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-493-2250
Mailing Address - Fax:914-493-2060
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:SUITE 2700
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-493-2250
Practice Address - Fax:914-493-2060
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262125207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03374196Medicaid
NYA400021171Medicare PIN