Provider Demographics
NPI:1902860653
Name:MEHRA-VERMA, PRITI (OD)
Entity type:Individual
Prefix:DR
First Name:PRITI
Middle Name:
Last Name:MEHRA-VERMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BLAKE DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2142
Mailing Address - Country:US
Mailing Address - Phone:917-497-9650
Mailing Address - Fax:
Practice Address - Street 1:12 BLAKE DR
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-2142
Practice Address - Country:US
Practice Address - Phone:917-497-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00593100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V04405Medicare UPIN
NYC380F1Medicare ID - Type Unspecified