Healthcare Provider Details

I. General information

NPI: 1386149276
Provider Name (Legal Business Name): APOORVA TRIVEDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2018
Last Update Date: 08/15/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 TRANSIT RD STE A
DEPEW NY
14043-1033
US

IV. Provider business mailing address

199 PARK CLUB LN STE 500
WILLIAMSVILLE NY
14221-5269
US

V. Phone/Fax

Practice location:
  • Phone: 716-845-1600
  • Fax: 716-242-0201
Mailing address:
  • Phone: 716-845-1300
  • Fax: 845-896-7758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number328435
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number328435
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: