Healthcare Provider Details

I. General information

NPI: 1730336959
Provider Name (Legal Business Name): SHEELA UDAYAN VINOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SUNDERLAND DR
MORRISTOWN NJ
07960-3622
US

IV. Provider business mailing address

3 SUNDERLAND DR
MORRISTOWN NJ
07960-3622
US

V. Phone/Fax

Practice location:
  • Phone: 973-984-7037
  • Fax:
Mailing address:
  • Phone: 973-984-7037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number25MA05011300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number25MA05011300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: