Provider Demographics
NPI:1871136648
Name:MEHRAJ, MONA (PT)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:MEHRAJ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5933 WINTERBERRY PL
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-8221
Mailing Address - Country:US
Mailing Address - Phone:615-738-8420
Mailing Address - Fax:
Practice Address - Street 1:397 HEMLOCK DR
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-9712
Practice Address - Country:US
Practice Address - Phone:570-386-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist