Provider Demographics
NPI:1578044285
Name:SUDIT, BELLA (OD)
Entity Type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:SUDIT
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 1:31 DUNNERDALE RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-1253
Mailing Address - Country:US
Mailing Address - Phone:973-216-0758
Mailing Address - Fax:
Practice Address - Street 1:3077 ROUTE 46
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1233
Practice Address - Country:US
Practice Address - Phone:973-658-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00683400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist