Provider Demographics
NPI:1336728765
Name:MEHTA, JIGNESH D (RPH)
Entity Type:Individual
Prefix:MR
First Name:JIGNESH
Middle Name:D
Last Name:MEHTA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 S WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4567
Mailing Address - Country:US
Mailing Address - Phone:908-862-4444
Mailing Address - Fax:
Practice Address - Street 1:937 S WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4567
Practice Address - Country:US
Practice Address - Phone:908-862-4444
Practice Address - Fax:908-862-6044
Is Sole Proprietor?:No
Enumeration Date:2021-04-04
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02468900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist