Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A114339 | CA |
N | 2084N0402X | Child Neurologist | 257272 | MA |
Y | 2084N0402X | Child Neurologist | 73746 | WI |
NPI | 1053613125 |
---|---|
Provider Name | Dr. Niyati Mehta |
First Address | Milwaukee, WI 53226-4874 |
Second Address | Milwaukee, WI 53226-4874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2010 |
Last Update Date | 22/07/2020 |