Provider Demographics
NPI:1003874090
Name:VAIDYA, PRITY S (MD)
Entity Type:Individual
Prefix:
First Name:PRITY
Middle Name:S
Last Name:VAIDYA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:335 GLESSNER AVE STE 1430
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-2269
Mailing Address - Country:US
Mailing Address - Phone:419-526-8044
Mailing Address - Fax:419-526-8854
Practice Address - Street 1:335 GLESSNER AVE STE 1430
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2269
Practice Address - Country:US
Practice Address - Phone:419-526-8044
Practice Address - Fax:419-526-8854
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2024-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35058615207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0841138Medicaid
OH0841138Medicaid