Provider Demographics
NPI:1578891172
Name:GERBER-MEHTA, TARA LEE (CRNP)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LEE
Last Name:GERBER-MEHTA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 S CEDAR CREST BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6207
Mailing Address - Country:US
Mailing Address - Phone:610-433-7571
Mailing Address - Fax:610-433-8075
Practice Address - Street 1:1275 S CEDAR CREST BLVD STE 2
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6207
Practice Address - Country:US
Practice Address - Phone:610-433-7571
Practice Address - Fax:610-433-8075
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010518363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner