Provider Demographics
NPI:1588839625
Name:NIRANJAN G TRIVEDI M D P C
Entity Type:Organization
Organization Name:NIRANJAN G TRIVEDI M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRANJAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:TRIVEDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-652-1120
Mailing Address - Street 1:208 WEST WHITE HORSE PIKE
Mailing Address - Street 2:P O BOX 907
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center