Provider Demographics
NPI:1982861118
Name:MEHTA, SEJAL D
Entity Type:Individual
Prefix:MISS
First Name:SEJAL
Middle Name:D
Last Name:MEHTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 NEWPORT PARKWAY
Mailing Address - Street 2:APT #606
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310
Mailing Address - Country:US
Mailing Address - Phone:201-680-8662
Mailing Address - Fax:
Practice Address - Street 1:7TH AND CLAYTON STREETS
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805
Practice Address - Country:US
Practice Address - Phone:302-575-8041
Practice Address - Fax:302-575-8050
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program