Healthcare Provider Details

I. General information

NPI: 1306378591
Provider Name (Legal Business Name): KRINA A VYAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRINA PATEL

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 E MIDLAND AVE STE 1A
PARAMUS NJ
07652-2926
US

IV. Provider business mailing address

PO BOX 29234
NEW YORK NY
10087-4776
US

V. Phone/Fax

Practice location:
  • Phone: 914-821-9311
  • Fax: 914-821-9313
Mailing address:
  • Phone: 914-821-9311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number309346
License Number StateNY

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: