Provider Demographics
NPI: | 1942248240 |
---|---|
Name: | MEHTA, HASIT (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | HASIT |
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: | 100 WOODS RD |
Mailing Address - Street 2: | WESTCHESTER MEDICAL CTR DEPT OF RADIOLOGY |
Mailing Address - City: | VALHALLA |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10595-1530 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 914-493-8158 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 100 WOODS RD |
Practice Address - Street 2: | WESTCHESTER MEDICAL CTR DEPT OF RADIOLOGY |
Practice Address - City: | VALHALLA |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10595-1530 |
Practice Address - Country: | US |
Practice Address - Phone: | 914-493-8158 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-06-02 |
Last Update Date: | 2013-03-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 235905 | 2085N0700X |
NY | 235905-1 | 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2085N0700X | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 02741968 | Medicaid | |
NY | 02741968 | Medicaid |