Individual
KETANKUMAR N VAIDYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2149 WOODBRIDGE AVE, EDISON, NJ 08817-4474
(732) 985-2151
(732) 985-0650
Mailing address
2149 WOODBRIDGE AVE, EDISON, NJ 08817-4474
(732) 985-2151
(732) 985-0650
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MA74514
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9002707
—
NJ
Enumeration date
07/11/2006
Last updated
03/28/2023
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