Healthcare Provider Details

I. General information

NPI: 1619943446
Provider Name (Legal Business Name): NIKETA VINOD GOVINDANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIKETA JAYANT PATEL MD

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 ESSEX ST STE 301
HACKENSACK NJ
07601-3246
US

IV. Provider business mailing address

PO BOX 1140
WARWICK NY
10990-8140
US

V. Phone/Fax

Practice location:
  • Phone: 551-202-7202
  • Fax: 201-742-5328
Mailing address:
  • Phone: 201-688-0823
  • Fax: 845-544-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA07894100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: