Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 233661-1 | NY |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 233661-1 | NY |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 233661-1 | NY |
N | 2081P2900X | Pain Medicine | 233661-1 | NY |
N | 2081S0010X | Sports Medicine | 233661-1 | NY |
N | 213ES0000X | Sports Medicine | 233661-1 | NY |
NPI | 1013077395 |
---|---|
Provider Name | Dr. Ariz Ruyintan Mehta |
First Address | Jersey City, NJ 07306-1112 |
Second Address | Jersey City, NJ 07306-1112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2006 |
Last Update Date | 14/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I72005 | (02) |