Organization
LIBERTY PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARSHAN G TRIVEDI (PHYSICIAN OWNER)
(845) 292-6684
Entity
Organization
Contact information
Practice address
39 OLD MONTICELLO RD, CATSKILL PROF PLAZA, FERNDALE, NY 12754
(845) 292-6684
(845) 292-6770
Mailing address
39 OLD MONTICELLO RD, FERNDALE, NY 12754
(845) 292-6684
(845) 292-6770
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
NY178764
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01131213
—
NY
Enumeration date
11/01/2006
Last updated
08/22/2020
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