Individual
MR. PRABHAS TRIVEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26 HIGHWAY 35 N, NEPTUNE, NJ 07753-4743
(732) 456-7777
(848) 251-2189
Mailing address
PO BOX 4979, TOMS RIVER, NJ 08754-4979
(732) 244-4700
(732) 244-2804
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
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