Provider Demographics
NPI:1740208107
Name:JOSHI, ANUJA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANUJA
Middle Name:
Last Name:JOSHI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANJUA
Other - Middle Name:
Other - Last Name:JOSHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:20 MILLTOWN RD STE 201
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4353
Practice Address - Country:US
Practice Address - Phone:845-279-6179
Practice Address - Fax:847-279-3619
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL047-928783152W00000X
NY007517152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046009284Medicaid
IL01635011OtherBLUE CROSS
206276Medicare ID - Type Unspecified
IL01635011OtherBLUE CROSS