Provider Demographics
NPI:1003194671
Name:SOOD, VARDAAN (OD)
Entity Type:Individual
Prefix:DR
First Name:VARDAAN
Middle Name:
Last Name:SOOD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 EXPRESS ST
Mailing Address - Street 2:C/O DAVIS VISION
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2404
Mailing Address - Country:US
Mailing Address - Phone:516-827-6727
Mailing Address - Fax:
Practice Address - Street 1:9 BOICES LN
Practice Address - Street 2:EMPIRE VISION CENTRES
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1512
Practice Address - Country:US
Practice Address - Phone:845-336-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007764152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist