Provider Demographics
NPI:1083089957
Name:VAIDYA, KRUNAL (PT)
Entity Type:Individual
Prefix:
First Name:KRUNAL
Middle Name:
Last Name:VAIDYA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 TICES LN APT 94
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2171
Mailing Address - Country:US
Mailing Address - Phone:347-722-2666
Mailing Address - Fax:
Practice Address - Street 1:1814 E 2ND ST STE 2
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1751
Practice Address - Country:US
Practice Address - Phone:908-288-7357
Practice Address - Fax:908-288-7748
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist