Provider Demographics
NPI:1407207715
Name:VAIDYA, SEJAL NEEL
Entity Type:Individual
Prefix:
First Name:SEJAL
Middle Name:NEEL
Last Name:VAIDYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 FOREST GLEN RD STE 435
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1489
Mailing Address - Country:US
Mailing Address - Phone:301-593-9035
Mailing Address - Fax:301-593-9036
Practice Address - Street 1:1400 FOREST GLEN RD STE 435
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1489
Practice Address - Country:US
Practice Address - Phone:301-593-9035
Practice Address - Fax:301-593-9036
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR180162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily