Provider Demographics
NPI:1548364763
Name:MEHTA, NEHA DALAL (DPT)
Entity type:Individual
Prefix:
First Name:NEHA
Middle Name:DALAL
Last Name:MEHTA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DARO CT
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9347
Mailing Address - Country:US
Mailing Address - Phone:973-224-3108
Mailing Address - Fax:
Practice Address - Street 1:14 DARO CT
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9347
Practice Address - Country:US
Practice Address - Phone:973-224-3108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01040800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ104972ZGJ0Medicare PIN