Healthcare Provider Details

I. General information

NPI: 1437360690
Provider Name (Legal Business Name): GIRISH TRIKHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2007
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6319 FLY RD STE 2A
EAST SYRACUSE NY
13057-4901
US

IV. Provider business mailing address

6319 FLY RD STE 2A
EAST SYRACUSE NY
13057-4901
US

V. Phone/Fax

Practice location:
  • Phone: 315-937-5797
  • Fax: 315-937-5203
Mailing address:
  • Phone: 315-937-5797
  • Fax: 315-937-5203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number244028
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number244028
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number244028-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number244028
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: