# SURENDRA R VASHI, D. MD.,P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912176793
- **Authorized official:** MRS. ROSIO M PALACIOS (OFFICE MANAGER)
- **Authorized official phone:** (973) 481-3981

## Contact information

- **Practice address:** 57 BROADWAY, NEWARK, NJ 07104-2503
- **Practice address phone:** (973) 481-3981
- **Practice address fax:** (973) 481-1082
- **Mailing address:** 57 BROADWAY, NEWARK, NJ 07104-2503
- **Mailing address phone:** (973) 481-3981
- **Mailing address fax:** (973) 481-1082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 17619 | NJ | Yes |

## Other

- **Enumeration date:** 02/26/2008
- **Last updated:** 02/26/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 13767 | DORAL | NJ |