Provider Demographics
NPI:1720303373
Name:MEHTA, HEERAL J (MD)
Entity Type:Individual
Prefix:DR
First Name:HEERAL
Middle Name:J
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HIRAL
Other - Middle Name:J
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:185 ROSEBERRY ST
Mailing Address - Street 2:FARLEY BLDG 2ND FLOOR
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865
Mailing Address - Country:US
Mailing Address - Phone:908-847-4025
Mailing Address - Fax:833-514-6843
Practice Address - Street 1:59 ROSEBERRY ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1627
Practice Address - Country:US
Practice Address - Phone:908-847-4025
Practice Address - Fax:833-514-6843
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA097719002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology