Individual
VANESSA VIDES
Active
Individual
VANESSA VIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MA12674800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
289520
BOARD OF REGISTRATION IN MEDICINE
MA
Enumeration date
06/29/2021
Last updated
07/14/2025
Update your record
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