Provider Demographics
NPI:1376508887
Name:VAISH, SNEHA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SNEHA
Middle Name:S
Last Name:VAISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2950 CLEVELAND CLINIC BLVD
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3609
Mailing Address - Country:US
Mailing Address - Phone:954-659-5188
Mailing Address - Fax:954-659-5189
Practice Address - Street 1:2950 CLEVELAND CLINIC BLVD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3609
Practice Address - Country:US
Practice Address - Phone:954-659-5188
Practice Address - Fax:954-659-5189
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ36192208800000X
MN52898390200000X
FLFV27331265208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ368446Medicaid
AZP00732875OtherRAILROAD MEDICARE
MNP00852254OtherRAILROAD MEDICARE
AZZ124679Medicare PIN