Basic Information
| Provider Information | |||||||||
| NPI: | 1851741532 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEHTA | ||||||||
| FirstName: | PRIYA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8200 FLOURTOWN AVENUE | ||||||||
| Address2: | STE 4 | ||||||||
| City: | WYNDMOOR | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190387969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152472292 | ||||||||
| FaxNumber: | 2152476885 | ||||||||
| Practice Location | |||||||||
| Address1: | 8200 FLOURTOWN AVENUE | ||||||||
| Address2: | STE 4 | ||||||||
| City: | WYNDMOOR | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190387969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152472292 | ||||||||
| FaxNumber: | 2152476885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2016 | ||||||||
| LastUpdateDate: | 04/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207KA0200X | MD467679 | PA | N | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | 2080P0201X | MD467679 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Allergy/Immunology | 207RA0201X | MD467679 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Allergy & Immunology |
No ID Information.