Provider Demographics
NPI:1639116353
Name:PARIKH, PALLAVI M (MD)
Entity Type:Individual
Prefix:DR
First Name:PALLAVI
Middle Name:M
Last Name:PARIKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 KRISTIN CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5798
Mailing Address - Country:US
Mailing Address - Phone:732-987-6080
Mailing Address - Fax:
Practice Address - Street 1:42 KRISTIN CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5798
Practice Address - Country:US
Practice Address - Phone:732-987-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04452800207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0303305Medicaid
NJ049653ZDSMMedicare PIN
NJ0303305Medicaid
NJ049653Medicare PIN