Provider Demographics
NPI:1982713038
Name:BEAR INTERNAL MEDICINE AND PEDIATRICS, PA
Entity Type:Organization
Organization Name:BEAR INTERNAL MEDICINE AND PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NEMISHH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-392-2200
Mailing Address - Street 1:1400 PEOPLES PLZ
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5707
Mailing Address - Country:US
Mailing Address - Phone:302-392-2200
Mailing Address - Fax:302-392-2226
Practice Address - Street 1:1400 PEOPLES PLZ
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5707
Practice Address - Country:US
Practice Address - Phone:302-392-2200
Practice Address - Fax:302-392-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007004207R00000X, 208000000X
DEC10007003208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty