Provider Demographics
NPI:1326832262
Name:KESAVAN, TRISHA
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:KESAVAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NORTHERN BOULEVARD, NORWELL HEALTH
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 NORTHERN BOULEVARD, NORWELL HEALTH
Practice Address - Street 2:SUITE 104
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548
Practice Address - Country:US
Practice Address - Phone:516-304-7234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program