Basic Information
| Provider Information | |||||||||
| NPI: | 1912496241 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTH HILLS EMG ASSOCIATES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 575 COAL VALLEY RD STE 277 | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124697722 | ||||||||
| FaxNumber: | 4124697721 | ||||||||
| Practice Location | |||||||||
| Address1: | 575 COAL VALLEY RD STE 277 | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124697722 | ||||||||
| FaxNumber: | 4124697721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2018 | ||||||||
| LastUpdateDate: | 05/02/2018 | ||||||||
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| AuthorizedOfficialLastName: | MEHTA | ||||||||
| AuthorizedOfficialFirstName: | RAJESH | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4124697722 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | PA | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.