Provider Demographics
NPI:1881862902
Name:TRIVEDI-GOMES, HEMA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:HEMA
Middle Name:
Last Name:TRIVEDI-GOMES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PENN PLZ
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10121-0101
Mailing Address - Country:US
Mailing Address - Phone:212-760-8107
Mailing Address - Fax:212-760-2785
Practice Address - Street 1:12307 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2115
Practice Address - Country:US
Practice Address - Phone:718-322-7320
Practice Address - Fax:718-322-7168
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist