Provider Demographics
NPI:1215994926
Name:PARIKH, DIVYANG (MD)
Entity type:Individual
Prefix:DR
First Name:DIVYANG
Middle Name:
Last Name:PARIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LITTLE CLOVE ROAD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301
Mailing Address - Country:US
Mailing Address - Phone:718-876-9600
Mailing Address - Fax:718-876-7773
Practice Address - Street 1:5 LITTLE CLOVE ROAD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301
Practice Address - Country:US
Practice Address - Phone:718-876-9600
Practice Address - Fax:718-876-7773
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157047207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00994990Medicaid
NY00994990Medicaid
BP0402608OtherDEA
A64600Medicare UPIN