Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD467679 | PA |
N | 2080P0201X | Pediatric Allergist | MD467679 | PA |
NPI | 1851741532 |
---|---|
Provider Name | Priya Mehta |
First Address | Wyndmoor, PA 19038-7969 |
Second Address | Wyndmoor, PA 19038-7969 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2016 |
Last Update Date | 02/09/2021 |