Healthcare Provider Details

I. General information

NPI: 1497761951
Provider Name (Legal Business Name): VASAVI HARISH PARIKH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 OVERLOOK RD STE 304
SUMMIT NJ
07901-3570
US

IV. Provider business mailing address

11 OAK LN
GREEN BROOK NJ
08812-1857
US

V. Phone/Fax

Practice location:
  • Phone: 908-598-0190
  • Fax: 908-598-1820
Mailing address:
  • Phone: 732-868-0409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA07409200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: