Provider Demographics
NPI:1881918985
Name:MEHTA, DHARA (PHARMD)
Entity type:Individual
Prefix:
First Name:DHARA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 PARSONS BLVD
Mailing Address - Street 2:APT #1C
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-6265
Mailing Address - Country:US
Mailing Address - Phone:718-358-7180
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist