Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD435772 | PA |
NPI | 1225148505 |
---|---|
Provider Name | Sonali Mehta |
First Address | Weirton, WV 26062-3770 |
Second Address | Pittsburgh, PA 15205-1024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 06/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1024310650002 | (05) | PA |
4700052 | (05) | MI |