Provider Demographics
NPI:1497087027
Name:MEHTA, KRUPA
Entity type:Individual
Prefix:
First Name:KRUPA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W 110TH ST
Mailing Address - Street 2:APT: 14
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-4135
Mailing Address - Country:US
Mailing Address - Phone:347-631-0518
Mailing Address - Fax:
Practice Address - Street 1:207 W 110TH ST
Practice Address - Street 2:APT: 14
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-4135
Practice Address - Country:US
Practice Address - Phone:347-631-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-07
Last Update Date:2010-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist