Provider Demographics
NPI:1013400043
Name:YEHUDAI, AVI DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:AVI
Middle Name:DAVID
Last Name:YEHUDAI
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 1:530 MAIN ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2669
Mailing Address - Country:US
Mailing Address - Phone:908-879-7070
Mailing Address - Fax:908-879-5323
Practice Address - Street 1:530 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2669
Practice Address - Country:US
Practice Address - Phone:908-879-7070
Practice Address - Fax:908-879-5323
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008785152W00000X
NJ27OA00680100152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management