Provider Demographics
NPI:1437903820
Name:BLUE DOOR MEDICAL PLLC
Entity type:Organization
Organization Name:BLUE DOOR MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-442-1115
Mailing Address - Street 1:301 E 79TH ST APT 7S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0935
Mailing Address - Country:US
Mailing Address - Phone:917-442-1115
Mailing Address - Fax:
Practice Address - Street 1:301 E 79TH ST APT 7S
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0935
Practice Address - Country:US
Practice Address - Phone:917-442-1115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty