Provider Demographics
NPI:1548685480
Name:MEHTA, JIGISHA
Entity type:Individual
Prefix:
First Name:JIGISHA
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 1:139 GRASSHOPPER DR
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-1625
Mailing Address - Country:US
Mailing Address - Phone:201-736-9840
Mailing Address - Fax:
Practice Address - Street 1:3265 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3712
Practice Address - Country:US
Practice Address - Phone:215-996-9809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-01
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458489183500000X
NJ28RI03619300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist