Basic Information
| Provider Information | |||||||||
| NPI: | 1093179848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEHTA | ||||||||
| FirstName: | NATASHA | ||||||||
| MiddleName: | CARY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 W 168TH ST # 4 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100323725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123056354 | ||||||||
| FaxNumber: | 2123056279 | ||||||||
| Practice Location | |||||||||
| Address1: | 622 W 168TH | ||||||||
| Address2: | VC 2 SUITE C -AIM | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100323720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123056364 | ||||||||
| FaxNumber: | 2123056279 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2016 | ||||||||
| LastUpdateDate: | 09/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 301475 | NY | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 301475 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.