Provider Demographics
NPI:1881831469
Name:MEHTA, PRITI J (MD)
Entity Type:Individual
Prefix:DR
First Name:PRITI
Middle Name:J
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:815 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2635
Mailing Address - Country:US
Mailing Address - Phone:732-393-0185
Mailing Address - Fax:888-225-7592
Practice Address - Street 1:904 OAK TREE AVE STE J
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080
Practice Address - Country:US
Practice Address - Phone:732-372-5063
Practice Address - Fax:888-225-7592
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-19
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08524100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0353655Medicaid
NJ800485ZXP2Medicare PIN