Provider Demographics
NPI:1093207201
Name:MISTRY, HETAL D (MD)
Entity type:Individual
Prefix:DR
First Name:HETAL
Middle Name:D
Last Name:MISTRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 CENTRE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1301
Mailing Address - Country:US
Mailing Address - Phone:412-692-4724
Mailing Address - Fax:412-692-4705
Practice Address - Street 1:5115 CENTRE AVE FL 2
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1301
Practice Address - Country:US
Practice Address - Phone:412-692-4724
Practice Address - Fax:412-692-4705
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD17735207R00000X
RILP04318207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILP04318OtherSTATE OF RHODE ISLAND