Provider Demographics
NPI:1366427585
Name:PARIKH, SUDHIR M (M D P A)
Entity type:Individual
Prefix:DR
First Name:SUDHIR
Middle Name:M
Last Name:PARIKH
Suffix:
Gender:M
Credentials:M D P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 NO THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904
Mailing Address - Country:US
Mailing Address - Phone:732-545-0094
Mailing Address - Fax:732-545-4087
Practice Address - Street 1:18 NO THIRD AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904
Practice Address - Country:US
Practice Address - Phone:732-545-0094
Practice Address - Fax:732-545-4087
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03358200207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJL5011OtherOXFORD
NJ0414905Medicaid
NJ1486261OtherCOVENTRY HEALTH-FIRST HEALTH
NJ0006615OtherGHI
NJ4097200OtherAETNA PPO
NJ0101321000OtherAMERIHEALTH
NJ15153OtherAMERIGROUP
NJ25MA03358200OtherHEALTHFIRST
NJ1017379OtherHORIZON N.J. FAMILYCARE
NJ205637OtherUS FAMILY
NJDD7820OtherRAILROAD MEDICARE
NJ0355054OtherCIGNA
NJ17A382OtherEMPIRE BC
NJ347301OtherUNITED HEALTHCARE
NJ8828709Medicaid
NJ01000122400OtherAMERICHOICE
NJ01098175OtherAMERIGROUP
NJ8828709Medicaid
NJ0414905Medicaid