Provider Demographics
NPI:1790350692
Name:NEHA MADHIWALA, OD PA
Entity Type:Organization
Organization Name:NEHA MADHIWALA, OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:NEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MADHIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-587-5405
Mailing Address - Street 1:34 BARTOW AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-4000
Mailing Address - Country:US
Mailing Address - Phone:732-587-5404
Mailing Address - Fax:
Practice Address - Street 1:839 ROUTE 130
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2907
Practice Address - Country:US
Practice Address - Phone:609-443-6484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty