Provider Demographics
NPI:1700343878
Name:MEHROTRA, NIKHIL (MBA)
Entity Type:Individual
Prefix:MR
First Name:NIKHIL
Middle Name:
Last Name:MEHROTRA
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36528 GRAND RIVER AVE STE A-3
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3016
Mailing Address - Country:US
Mailing Address - Phone:248-640-9305
Mailing Address - Fax:248-987-6866
Practice Address - Street 1:36528 GRAND RIVER AVE STE A-3
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-3016
Practice Address - Country:US
Practice Address - Phone:248-640-9305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care