Provider Demographics
NPI:1609800564
Name:VAYDOVSKY, JOSEPH (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:VAYDOVSKY
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 1:108 SERPENTINE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751
Mailing Address - Country:US
Mailing Address - Phone:732-851-5928
Mailing Address - Fax:732-324-4293
Practice Address - Street 1:485 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861
Practice Address - Country:US
Practice Address - Phone:732-324-4290
Practice Address - Fax:732-324-4293
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA079059207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0091367Medicaid
I49806Medicare UPIN
NJ098407NSVMedicare ID - Type Unspecified