Provider Demographics
NPI:1477677979
Name:VAIDIAN, ANIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:
Last Name:VAIDIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SANITORIUM RD
Mailing Address - Street 2:BLDG D
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3555
Mailing Address - Country:US
Mailing Address - Phone:845-364-2512
Mailing Address - Fax:845-364-2628
Practice Address - Street 1:50 SANITORIUM RD
Practice Address - Street 2:BLDG D
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3555
Practice Address - Country:US
Practice Address - Phone:845-364-2512
Practice Address - Fax:845-364-2628
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199508-1261QP0905X
NY207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Not Answered207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease