Provider Demographics
NPI:1568643112
Name:PATEL, VAIHARI (OD)
Entity Type:Individual
Prefix:
First Name:VAIHARI
Middle Name:
Last Name:PATEL
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 1:112 EISENHOWER PKWY
Mailing Address - Street 2:LENSCRAFTERS DR'S OFFICE
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4995
Mailing Address - Country:US
Mailing Address - Phone:973-535-1171
Mailing Address - Fax:
Practice Address - Street 1:390 W BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4476
Practice Address - Country:US
Practice Address - Phone:646-613-7401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007230152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist