Basic Information
Provider Information
NPI: 1942281217
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEHTA
FirstName: HARSHAD
MiddleName: RATILAL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 BOWER HILL RD
Address2: ATTN PAMALYN AFFILIATE BILLING
City: PITTSBURGH
State: PA
PostalCode: 152431873
CountryCode: US
TelephoneNumber: 4129242548
FaxNumber:  
Practice Location
Address1: 1050 BOWER HILL RD STE 308
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152431870
CountryCode: US
TelephoneNumber: 4123444767
FaxNumber: 4123440405
Other Information
ProviderEnumerationDate: 11/14/2005
LastUpdateDate: 03/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XMD019844EPAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

ID Information
IDTypeStateIssuerDescription
206116701 AETNAOTHER
00000008674801 UNISON HEALTH PLANOTHER
000734114000305PA MEDICAID
150147201 GATEWAY HEALTH PLANOTHER
04872001PAHIGHMARK BLUE SHIELDOTHER
06001191601 RAILROAD MEDICAREOTHER
8715001 HEALTH AMERICAOTHER


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