Healthcare Provider Details
I. General information
NPI: 1750309589
Provider Name (Legal Business Name): SUDHIR M PARIKH M D P A
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/18/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18 N 3RD AVE
HIGHLAND PARK NJ
08904-2408
US
IV. Provider business mailing address
18 N 3RD AVE
HIGHLAND PARK NJ
08904-2408
US
V. Phone/Fax
- Phone: 732-545-0094
- Fax: 732-545-4087
- Phone: 732-545-0094
- Fax: 732-545-4087
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUDHIR
M
PARIKH
Title or Position: OWNER OF CORPORATION
Credential: M D PA
Phone: 732-545-0094