Healthcare Provider Details

I. General information

NPI: 1922852623
Provider Name (Legal Business Name): YASH TRIVEDI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 12/19/2024
Certification Date:
Deactivation Date: 12/12/2024
Reactivation Date: 12/19/2024

III. Provider practice location address

2201 HEMPSTEAD TURNPIKE
EAST MEADOW NY
11554
US

IV. Provider business mailing address

2201 HEMPSTEAD TURNPIKE
EAST MEADOW NY
11554
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-0123
  • Fax: 516-572-5609
Mailing address:
  • Phone: 516-572-6501
  • Fax: 516-572-5609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: