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Individual

TEJAL MEHTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1000 E MOUNTAIN BLVD, WILKES BARRE, PA 18711-0027
(570) 808-7850
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25MA08936200
NJ
207L00000X
Anesthesiology Physician
Primary
MD461779
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0265497
NJ
Enumeration date
04/22/2011
Last updated
07/21/2022
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