Provider Demographics
NPI:1942465521
Name:MEHTA & MEHTA PHYSICIANS PC
Entity Type:Organization
Organization Name:MEHTA & MEHTA PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANJANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-878-1543
Mailing Address - Street 1:41 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940-1209
Mailing Address - Country:US
Mailing Address - Phone:631-878-1543
Mailing Address - Fax:631-878-5587
Practice Address - Street 1:36 OSPREY AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-7303
Practice Address - Country:US
Practice Address - Phone:631-727-4171
Practice Address - Fax:631-727-3660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198176207R00000X
NY197342207RG0100X
NY170734207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty