Healthcare Provider Details

I. General information

NPI: 1841697109
Provider Name (Legal Business Name): NIRMAL I. TRIVEDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 HERRONTOWN RD
PRINCETON NJ
08540-1901
US

IV. Provider business mailing address

905 HERRONTOWN RD
PRINCETON NJ
08540-1901
US

V. Phone/Fax

Practice location:
  • Phone: 609-497-3327
  • Fax:
Mailing address:
  • Phone: 609-497-3327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA09586300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: