Healthcare Provider Details

I. General information

NPI: 1346455078
Provider Name (Legal Business Name): NARENDRA K TRIVEDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 BROADWAY STE D2
AMITYVILLE NY
11701-2731
US

IV. Provider business mailing address

137 BROADWAY STE D2
AMITYVILLE NY
11701-2731
US

V. Phone/Fax

Practice location:
  • Phone: 516-822-2290
  • Fax: 516-822-2290
Mailing address:
  • Phone: 516-822-2290
  • Fax: 516-822-2290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number121873
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: