Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 35058615 | OH |
NPI | 1003874090 |
---|---|
Provider Name | Prity S Vaidya |
First Address | Mansfield, OH 44903-2269 |
Second Address | Mansfield, OH 44903-2269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 25/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0841138 | (05) | OH |