1841329612 NPI number — DR. TRUSHNA PATEL MEHTA PHARMD

Table of content: DR. TRUSHNA PATEL MEHTA PHARMD (NPI 1841329612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841329612 NPI number — DR. TRUSHNA PATEL MEHTA PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEHTA
Provider First Name:
TRUSHNA
Provider Middle Name:
PATEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841329612
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10630 KENILWORTH AVE
Provider Second Line Business Mailing Address:
APT 201
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20814-4267
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-498-7070
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10410 KENSINGTON PKWY
Provider Second Line Business Practice Location Address:
UNIT 100B
Provider Business Practice Location Address City Name:
KENSINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20895-2943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-929-3634
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  18102 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)