Provider Demographics
NPI:1609987106
Name:MEHTA BARIATRIC CENTER
Entity Type:Organization
Organization Name:MEHTA BARIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-924-0200
Mailing Address - Street 1:1 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-9590
Mailing Address - Country:US
Mailing Address - Phone:609-924-0200
Mailing Address - Fax:609-924-0201
Practice Address - Street 1:1 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-9590
Practice Address - Country:US
Practice Address - Phone:609-924-0200
Practice Address - Fax:609-924-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA072620261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH49243Medicare UPIN
NJ074646Medicare ID - Type Unspecified