Provider Demographics
NPI:1790477263
Name:TRIVEDI, ANTIKA
Entity Type:Individual
Prefix:
First Name:ANTIKA
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W 35TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2538
Mailing Address - Country:US
Mailing Address - Phone:833-646-3222
Mailing Address - Fax:833-646-3222
Practice Address - Street 1:359 INVERNESS DR S STE J
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5843
Practice Address - Country:US
Practice Address - Phone:833-646-3222
Practice Address - Fax:833-646-3222
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician