Provider Demographics
NPI:1790705820
Name:MEHTA, CHIRAG A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:A
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:96 MILLBURN AVE
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1944
Mailing Address - Country:US
Mailing Address - Phone:973-763-6800
Mailing Address - Fax:973-763-1255
Practice Address - Street 1:96 MILLBURN AVE
Practice Address - Street 2:SUITE 200A
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1944
Practice Address - Country:US
Practice Address - Phone:973-763-6800
Practice Address - Fax:973-763-1255
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2019-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07675500207RS0012X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ112801TM8Medicare PIN