Provider Demographics
NPI:1306839097
Name:MEHTA, BIJAL SHAH (MD)
Entity type:Individual
Prefix:DR
First Name:BIJAL
Middle Name:SHAH
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:435 SOUTH ST STE 350
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6474
Practice Address - Country:US
Practice Address - Phone:973-971-6700
Practice Address - Fax:973-290-7480
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09613100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01863767Medicaid
NYG66573Medicare UPIN
NY30N93Medicare ID - Type Unspecified