Provider Demographics
NPI:1649250697
Name:MEHRA, DEEPTI (MD)
Entity type:Individual
Prefix:DR
First Name:DEEPTI
Middle Name:
Last Name:MEHRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 W SYLVANIA AVE
Mailing Address - Street 2:#233-A
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-5977
Mailing Address - Country:US
Mailing Address - Phone:732-988-8076
Mailing Address - Fax:
Practice Address - Street 1:200 WHITE RD
Practice Address - Street 2:SUITE 213
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1150
Practice Address - Country:US
Practice Address - Phone:732-741-5600
Practice Address - Fax:732-345-1001
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07009100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics