Healthcare Provider Details

I. General information

NPI: 1437903820
Provider Name (Legal Business Name): BLUE DOOR MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 79TH ST APT 7S
NEW YORK NY
10075-0935
US

IV. Provider business mailing address

301 E 79TH ST APT 7S
NEW YORK NY
10075-0935
US

V. Phone/Fax

Practice location:
  • Phone: 917-442-1115
  • Fax:
Mailing address:
  • Phone: 917-442-1115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NAYANA PAREKH
Title or Position: OWNER
Credential: MD
Phone: 917-442-1115