Provider Demographics
NPI:1497202808
Name:UDARE, VIDHYA R (MS)
Entity Type:Individual
Prefix:MRS
First Name:VIDHYA
Middle Name:R
Last Name:UDARE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:VIDHYA
Other - Middle Name:
Other - Last Name:UDARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CNS, BHMS, CCH
Mailing Address - Street 1:35 RAVENSWOOD CT
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-4000
Mailing Address - Country:US
Mailing Address - Phone:732-822-9651
Mailing Address - Fax:
Practice Address - Street 1:35 RAVENSWOOD CT
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-4000
Practice Address - Country:US
Practice Address - Phone:732-491-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist