Individual
DR. KAVITA MARIWALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1253 MONTAUK HIGHWAY, WEST ISLIP, NY 11795-4916
(631) 665-3376
(631) 969-3370
Mailing address
1253 MONTAUK HIGHWAY, WEST ISLIP, NY 11795-4916
(631) 665-3376
(631) 969-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
046352
CT
207N00000X
Dermatology Physician
253189
NY
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
046352
CT
207ND0101X
MOHS-Micrographic Surgery Physician
253189
NY
Other
Enumeration date
03/27/2008
Last updated
09/28/2020
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