Basic Information
| Provider Information | |||||||||
| NPI: | 1114516838 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRIVEDI | ||||||||
| FirstName: | JUHI | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 107 CHARDON CT | ||||||||
| Address2: | |||||||||
| City: | MORGANVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077514439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327721525 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3141 CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191042816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158952000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2021 | ||||||||
| LastUpdateDate: | 01/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.