Basic Information
Provider Information
NPI: 1801384854
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARIKH
FirstName: SHIVANI
MiddleName: JAYESH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 909
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402010909
CountryCode: US
TelephoneNumber: 5025880325
FaxNumber:  
Practice Location
Address1: 401 E CHESTNUT ST UNIT 470
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402025704
CountryCode: US
TelephoneNumber: 5025884400
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/25/2018
LastUpdateDate: 07/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207V00000X56464KYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home