Individual
MR. PRABHAS TRIVEDI
Active
Individual
MR. PRABHAS TRIVEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA07651700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0310573
—
NJ
01
—
076559
MEDICARE PTAN
NJ
01
—
1101489
AMERIGROUP
NJ
01
—
P5490287
OXFORD
NJ
Enumeration date
05/11/2006
Last updated
08/04/2021
Update your record
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