Provider Demographics
NPI:1568072379
Name:CHAUDHARI, NISHA ARVIND (OD)
Entity Type:Individual
Prefix:
First Name:NISHA
Middle Name:ARVIND
Last Name:CHAUDHARI
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 1:21 KRISTEN CT
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-9687
Mailing Address - Country:US
Mailing Address - Phone:732-977-6521
Mailing Address - Fax:
Practice Address - Street 1:87 NASSAU ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-3710
Practice Address - Country:US
Practice Address - Phone:732-977-6521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00699000152W00000X
NY009236152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist