Provider Demographics
NPI:1619943446
Name:GOVINDANI, NIKETA VINOD (MD)
Entity Type:Individual
Prefix:DR
First Name:NIKETA
Middle Name:VINOD
Last Name:GOVINDANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIKETA
Other - Middle Name:JAYANT
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1140
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-8140
Mailing Address - Country:US
Mailing Address - Phone:201-688-0823
Mailing Address - Fax:845-544-2220
Practice Address - Street 1:211 ESSEX ST STE 301
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3246
Practice Address - Country:US
Practice Address - Phone:551-202-7202
Practice Address - Fax:201-742-5328
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07894100207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
093114PENMedicare ID - Type Unspecified
I35976Medicare UPIN