Individual
DR. JESSICA V VAIDYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4930 BROADWAY, NEW YORK, NY 10034-3182
(917) 261-6131
Mailing address
132 E 45TH ST APT 6A, NEW YORK, NY 10017-3117
(216) 926-6098
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
009216
NY
Other
Enumeration date
08/06/2020
Last updated
08/15/2022
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