Provider Demographics
NPI:1316648264
Name:TRIVEDI, NIRALI PARAG
Entity type:Individual
Prefix:
First Name:NIRALI
Middle Name:PARAG
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OLD WOODS AVE SE APT 341
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-1431
Mailing Address - Country:US
Mailing Address - Phone:732-731-9500
Mailing Address - Fax:
Practice Address - Street 1:16 OLD WOODS AVE SE APT 341
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-1431
Practice Address - Country:US
Practice Address - Phone:732-731-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program