Provider Demographics
NPI:1558306886
Name:TRIVEDI, NIRANJAN G (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRANJAN
Middle Name:G
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:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NJ
Mailing Address - Zip Code:08240-0907
Mailing Address - Country:US
Mailing Address - Phone:609-652-1120
Mailing Address - Fax:609-652-8023
Practice Address - Street 1:208 WEST WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240
Practice Address - Country:US
Practice Address - Phone:609-652-1120
Practice Address - Fax:609-652-8023
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA 037630207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2301045000OtherAMERIHEALTH SPECIALIST
NJ40161OtherUNIVERSITY HEALTH PLAN
NJ1135671OtherHORIZON HEALTH
NJ209090OtherUS FAMILY
NJ428234OtherUHC
NJ11043841OtherMULTIPLAN
NJP1968942OtherOXFORD
NJ0786029OtherCIGNA
NJ1K6464OtherHEALTHNET
NJ2253158OtherAETNA HMO
NJ2301045001OtherAMERIHEALTH INT MED
NJ3261409Medicaid
NJ4059662OtherAETNA PPO
NJ1K6464OtherHEALTHNET
NJ209090OtherUS FAMILY