Provider Demographics
NPI:1205668530
Name:DR KULDIP VAID MD PC
Entity type:Organization
Organization Name:DR KULDIP VAID MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KULDIP
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:VAID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-286-5854
Mailing Address - Street 1:454 BROADWAY STE 106
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-3050
Mailing Address - Country:US
Mailing Address - Phone:781-286-5854
Mailing Address - Fax:781-286-3971
Practice Address - Street 1:454 BROADWAY STE 106
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3050
Practice Address - Country:US
Practice Address - Phone:781-286-5854
Practice Address - Fax:781-286-3971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty