Provider Demographics
NPI:1134139256
Name:PARIKH, GEETA SURYALEANT (MD)
Entity Type:Individual
Prefix:MRS
First Name:GEETA
Middle Name:SURYALEANT
Last Name:PARIKH
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 1:1080 SUNRISE HWY
Mailing Address - Street 2:MAXINE S POSTAL TRI COMMUNITY HEATH CENTER
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701
Mailing Address - Country:US
Mailing Address - Phone:631-854-1006
Mailing Address - Fax:631-854-1031
Practice Address - Street 1:1080 SUNRISE HWY
Practice Address - Street 2:MAXINE S POSTAL TRI COMMUNITY HEATH CENTER
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701
Practice Address - Country:US
Practice Address - Phone:631-854-1006
Practice Address - Fax:631-854-1031
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130428208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01890880Medicaid
NY01890880Medicaid
E44873Medicare UPIN