Provider Demographics
NPI:1508838525
Name:SHROFF-MEHTA, VIRAJ O (MD)
Entity Type:Individual
Prefix:
First Name:VIRAJ
Middle Name:O
Last Name:SHROFF-MEHTA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:31 ROCHE BROS WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1032
Mailing Address - Country:US
Mailing Address - Phone:508-535-3376
Mailing Address - Fax:508-535-3377
Practice Address - Street 1:31 ROCHE BROS WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1032
Practice Address - Country:US
Practice Address - Phone:508-535-3376
Practice Address - Fax:508-535-3377
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2009-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA160425207NI0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3196798Medicaid
MAA30098Medicare PIN
MAH01790Medicare UPIN