Provider Demographics
NPI:1801860903
Name:BIGELOW, NIRAV OZA (PHD, PSYD)
Entity Type:Individual
Prefix:DR
First Name:NIRAV
Middle Name:OZA
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:PHD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 PRO-MED LN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5317
Mailing Address - Country:US
Mailing Address - Phone:317-843-9922
Mailing Address - Fax:317-581-3918
Practice Address - Street 1:703 PRO-MED LN
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5317
Practice Address - Country:US
Practice Address - Phone:317-843-9922
Practice Address - Fax:317-581-3918
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041948A103G00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent