Provider Demographics
NPI:1427372952
Name:TRIVEDI, SAUMIL HARDEV (MD)
Entity Type:Individual
Prefix:DR
First Name:SAUMIL
Middle Name:HARDEV
Last Name:TRIVEDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:889 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1917
Mailing Address - Country:US
Mailing Address - Phone:718-594-3840
Mailing Address - Fax:
Practice Address - Street 1:239 HIGBIE LN
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-2825
Practice Address - Country:US
Practice Address - Phone:631-376-6000
Practice Address - Fax:631-376-6031
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003482208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics