Provider Demographics
NPI:1255398509
Name:PARIKH, SUVARNA P (MD CMCM)
Entity type:Individual
Prefix:
First Name:SUVARNA
Middle Name:P
Last Name:PARIKH
Suffix:
Gender:F
Credentials:MD CMCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:WICKATUNK
Mailing Address - State:NJ
Mailing Address - Zip Code:07765
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:702 NORTH BEERS STREET
Practice Address - Street 2:STE 2
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733
Practice Address - Country:US
Practice Address - Phone:732-264-7755
Practice Address - Fax:732-264-8858
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA32106208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
D06510Medicare UPIN
451078Medicare ID - Type Unspecified