Provider Demographics
NPI:1144382946
Name:SETHI, SIMI BHARDWAJ (OD)
Entity Type:Individual
Prefix:DR
First Name:SIMI
Middle Name:BHARDWAJ
Last Name:SETHI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CRESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1946
Mailing Address - Country:US
Mailing Address - Phone:609-345-3000
Mailing Address - Fax:
Practice Address - Street 1:1440 ATLANTIC AVE
Practice Address - Street 2:SAI VISION CARE LLC DBA FAMILY VISION CARE
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-8006
Practice Address - Country:US
Practice Address - Phone:609-345-3000
Practice Address - Fax:609-345-1494
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1050-OD152W00000X
VA0618001603152W00000X
NJ27OA006618800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0210315Medicaid
NJ172918Medicare PIN