Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | ||
N | 225100000X | Physical Therapist | 40QA01253200 | NJ |
N | 2251G0304X | Physical Therapist - Geriatrics | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1144415464 |
---|---|
Provider Name | Dr. Heeral Mehta |
First Address | Hyde Park, NY 12538 |
Second Address | Poughkeepsie, NY 12601-3968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2007 |
Last Update Date | 16/04/2020 |