1043609886 NPI number — DR. VIJAY TRIVEDI

Table of content: DR. VIJAY TRIVEDI (NPI 1043609886)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043609886 NPI number — DR. VIJAY TRIVEDI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRIVEDI
Provider First Name:
VIJAY
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043609886
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
243 ROGERS ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REGINA
Provider Business Mailing Address State Name:
SK
Provider Business Mailing Address Postal Code:
S4S7C5
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
306-584-3326
Provider Business Mailing Address Fax Number:
306-766-4134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NUCLEAR MEDICINE REGINA GEN HOSP1440 14THE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REGINA
Provider Business Practice Location Address State Name:
SK
Provider Business Practice Location Address Postal Code:
S4S7C5
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
306-766-4156
Provider Business Practice Location Address Fax Number:
306-766-4134
Provider Enumeration Date:
01/16/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207UN0901X , with the licence number:  15952 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207UN0903X , with the licence number: 15952 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)