Provider Demographics
NPI:1700087665
Name:TRIVEDI, HEATHER ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ANNE
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 EASTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2663
Mailing Address - Country:US
Mailing Address - Phone:646-670-5120
Mailing Address - Fax:
Practice Address - Street 1:1628 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2663
Practice Address - Country:US
Practice Address - Phone:646-670-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233029207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease