Healthcare Provider Details

I. General information

NPI: 1053322164
Provider Name (Legal Business Name): RAJENDRA M TRIVEDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 11/09/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 BALDPATE RD
GEORGETOWN MA
01833-2303
US

IV. Provider business mailing address

83 BALDPATE RD
GEORGETOWN MA
01833-2303
US

V. Phone/Fax

Practice location:
  • Phone: 781-376-1771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number48439
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: