Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 022021 | NY |
NPI | 1063904910 |
---|---|
Provider Name | Miss Misri Mehta |
First Address | Secaucus, NJ 07094-3004 |
Second Address | New York, NY 10011-8002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2018 |
Last Update Date | 05/06/2018 |