1467695692 NPI number — DR. DHWANI PARIKH M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467695692 NPI number — DR. DHWANI PARIKH M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

PARIKH

Provider First Name:

DHWANI

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

PARIKH

Provider Other First Name:

DHWANI

Provider Other Middle Name:

Provider Other Name Prefix Text:

DR.

Provider Other Name Suffix Text:

Provider Other Credential Text:

M.D.

Provider Other Last Name Type Code:

5

NPI Number:

1467695692

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/05/2016

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 416457

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BOSTON

Provider Business Mailing Address State Name:

MA

Provider Business Mailing Address Postal Code:

02241-6457

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

651 WILLOW GROVE ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

HACKETTSTOWN

Provider Business Practice Location Address State Name:

NJ

Provider Business Practice Location Address Postal Code:

07840-1799

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

908-441-1502

Provider Business Practice Location Address Fax Number:

908-441-1167

Provider Enumeration Date:

04/17/2009

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0001X , with the licence number: 274212-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0001X , with the licence number: 25MA09339900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: P01366879 . This is a "RR MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 1304938P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 274212-A1Q . This is a "HEALTH FIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 9805990 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 02790704 . This is a "AMERIGROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 1302605P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 140829000137 . This is a "FIDELIS CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 370658 . This is a "US FAMILY HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 03916149 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 3862985 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".