Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 007764 | NY |
NPI | 1003194671 |
---|---|
Provider Name | Dr. Vardaan Sood |
First Address | Plainview, NY 11803-2404 |
Second Address | Kingston, NY 12401-1512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2011 |
Last Update Date | 29/07/2011 |