MEDICARE: NETREE PANDYA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	27OA00737900	NJ
2	152W00000X	Optometrist	32100097	PA

General Provider Information

NPI Number	:	1891588414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NETREE PANDYA

Provider Business Mailing Address
First Line	:	420 MOUNTAIN AVE FL 4
Second Line	:
City	:	NEW PROVIDENCE
State	:	NJ
Zip	:	07974-2736
Country	:	US
Telephone Number	:	908-458-8333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 WHITEHORSE MERCERVILLE RD
Second Line	:
City	:	TRENTON
State	:	NJ
Zip	:	08619-3800
Country	:	US
Telephone Number	:	609-890-0772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2025
Last Update Date	:	09/05/2025

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Directions to “ NETREE PANDYA ” Practice Location

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