Provider Demographics
NPI:1285615310
Name:MEHTA, MEENA (MD)
Entity type:Individual
Prefix:DR
First Name:MEENA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 ORNAC
Mailing Address - Street 2:SUITE 610
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-4181
Mailing Address - Country:US
Mailing Address - Phone:978-371-7778
Mailing Address - Fax:978-369-9514
Practice Address - Street 1:131 ORNAC
Practice Address - Street 2:SUITE 610
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-4181
Practice Address - Country:US
Practice Address - Phone:978-371-7778
Practice Address - Fax:978-369-9514
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78055207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF76305Medicare UPIN
MAJ14497Medicare ID - Type UnspecifiedMEDICARE