Provider Demographics
NPI:1316263858
Name:MEHTA, REENA S (MD)
Entity type:Individual
Prefix:
First Name:REENA
Middle Name:S
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 1:2620 JENA ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6348
Mailing Address - Country:US
Mailing Address - Phone:504-605-5351
Mailing Address - Fax:877-637-9467
Practice Address - Street 1:2620 JENA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6348
Practice Address - Country:US
Practice Address - Phone:504-605-5351
Practice Address - Fax:877-637-9467
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09569300207K00000X, 207K00000X
LAMD207K00000X
PAMD451982207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty