Provider Demographics
NPI:1518247600
Name:PARIKH, KEYUR (MD)
Entity Type:Individual
Prefix:
First Name:KEYUR
Middle Name:
Last Name:PARIKH
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 1:1422 WOOLWORTH ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2411
Mailing Address - Country:US
Mailing Address - Phone:312-213-7271
Mailing Address - Fax:
Practice Address - Street 1:1422 WOOLWORTH ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2411
Practice Address - Country:US
Practice Address - Phone:312-213-7271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262653207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04670020Medicaid