Individual
SHIVANI MEHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 525-8763
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 525-8763
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085003670
IL
363A00000X
Physician Assistant
Primary
PA3925
MA
Other
Enumeration date
01/15/2010
Last updated
01/15/2010
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