Provider Demographics
NPI:1912030347
Name:VAIDYA, PRITI P (CTRS)
Entity Type:Individual
Prefix:MISS
First Name:PRITI
Middle Name:P
Last Name:VAIDYA
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 LEXINGTON AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8152
Mailing Address - Country:US
Mailing Address - Phone:678-463-7258
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH ST FL 16
Practice Address - Street 2:BOX 142
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50246282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital