Basic Information
| Provider Information | |||||||||
| NPI: | 1366691586 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VAIDYA | ||||||||
| FirstName: | SONIA | ||||||||
| MiddleName: | PAREKH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 JILL CT | ||||||||
| Address2: | |||||||||
| City: | MONMOUTH JUNCTION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088522623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476516983 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1 EXECUTIVE DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | MONMOUTH JUNCTION | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088522407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322977575 | ||||||||
| FaxNumber: | 7322979493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2008 | ||||||||
| LastUpdateDate: | 08/07/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 046010153 | IL | N | Eye and Vision Services Providers | Optometrist | 152W00000X | ODTG00547 | RI | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.