Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kavita Mariwalla, MD

Individual provider Dermatology Physician · NPI 1962674184

Dr. Kavita Mariwalla, MD is a Micrographic Dermatologic Surgery (Mds) in West Islip, New York. Graduated from Yale University School of Medicine in 2004, 22 years ago. Practices with Mariwalla Dermatology PLLC, a 4-clinician group and accepts Medicare assignment. Licensed in Connecticut and New York.

Years since qualifying
22
Trained at
Yale University School of Medicine
Licensed in
CT, NY
In the registry since
2008
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1253 Montauk Hwy
West Islip, NY 11795-4916
Phone: (631) 665-3376
Fax: (631) 969-3370
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence 046352 (CT)
Dermatology Physician Taxonomy 207N00000X · Licence 046352 (CT)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence 253189 (NY)
Dermatology Physician Taxonomy 207N00000X · Licence 253189 (NY)

Record details

NPI number1962674184
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 27, 2008
Last updated in NPPESSeptember 28, 2020
Certification dateSeptember 28, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMICROGRAPHIC DERMATOLOGIC SURGERY (MDS)
Also practisesDERMATOLOGY
Medical schoolYALE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Mariwalla Dermatology Pllc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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