MEDICARE: DR. PRITI NIMISH PARIKH D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	045703	NY

General Provider Information

NPI Number	:	1598754707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRITI NIMISH PARIKH D.D.S.

Provider Business Mailing Address
First Line	:	1246 INMAN AVE
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08820-1111
Country	:	US
Telephone Number	:	718-794-0384
Fax Number	:	718-794-0789

Provider Business Practice Location Address
First Line	:	1211B PUGSLEY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-5040
Country	:	US
Telephone Number	:	718-794-0384
Fax Number	:	718-794-0789

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	08/30/2007

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