Healthcare Provider Details

I. General information

NPI: 1689889321
Provider Name (Legal Business Name): NARENDRA K. TRIVEDI, M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FIELD LN
MILLER PLACE NY
11764-2432
US

IV. Provider business mailing address

5 FIELD LN
MILLER PLACE NY
11764-2432
US

V. Phone/Fax

Practice location:
  • Phone: 631-500-9101
  • Fax: 631-500-9101
Mailing address:
  • Phone: 631-500-9101
  • Fax: 631-500-9101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NARENDRA K TRIVEDI
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 516-662-9872