Provider Demographics
NPI: | 1922147107 |
---|---|
Name: | VIPUL PARIKH MD PA |
Entity type: | Organization |
Organization Name: | VIPUL PARIKH MD PA |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICIAN |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | VIPUL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PARIKH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 732-240-1100 |
Mailing Address - Street 1: | 3 PLAZA DR |
Mailing Address - Street 2: | SUITE 9 |
Mailing Address - City: | TOMS RIVER |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08757-3759 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 732-240-1100 |
Mailing Address - Fax: | 732-240-1127 |
Practice Address - Street 1: | 3 PLAZA DR |
Practice Address - Street 2: | SUITE 9 |
Practice Address - City: | TOMS RIVER |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08757-3759 |
Practice Address - Country: | US |
Practice Address - Phone: | 732-240-1100 |
Practice Address - Fax: | 732-240-1127 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-05 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | MA068822 | 173000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 173000000X | Other Service Providers | Legal Medicine | Group - Single Specialty |