Provider Demographics
NPI:1588677355
Name:MEHTA, RAJESH (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COAL VALLEY RD
Mailing Address - Street 2:277
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3730
Mailing Address - Country:US
Mailing Address - Phone:412-469-7722
Mailing Address - Fax:412-469-7721
Practice Address - Street 1:575 COAL VALLEY RD
Practice Address - Street 2:277
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3730
Practice Address - Country:US
Practice Address - Phone:412-469-7722
Practice Address - Fax:412-469-7721
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052535L2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014952610001Medicaid
PA00723493OtherBSPA
1398027OtherBS
PA0014952610001Medicaid
PA723493Medicare PIN