Provider Demographics
NPI:1770665135
Name:VASOYA, PRAVIN B (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAVIN
Middle Name:B
Last Name:VASOYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PRAVIN
Other - Middle Name:BECHARBHAI
Other - Last Name:VASOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:438 GANTTOWN RD
Mailing Address - Street 2:WASHINGTON TWP NEUROLOGY ASOC GANTTOWN PLAZA SUITE B-3
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2341
Mailing Address - Country:US
Mailing Address - Phone:856-256-2600
Mailing Address - Fax:856-256-2516
Practice Address - Street 1:438 GANTTOWN RD
Practice Address - Street 2:WASHINGTON TWP NEUROLOGY ASOC GANTTOWN PLAZA SUITE B-3
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2341
Practice Address - Country:US
Practice Address - Phone:856-256-2600
Practice Address - Fax:856-256-2516
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA073685002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH21657Medicare UPIN