Healthcare Provider Details

I. General information

NPI: 1902961469
Provider Name (Legal Business Name): GITTA SONIA VASHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CROSS RIVER RD HEALTH SERVICES
KATONAH NY
10536-3549
US

IV. Provider business mailing address

494 WEST ST
FORT LEE NJ
07024-3431
US

V. Phone/Fax

Practice location:
  • Phone: 914-763-8151
  • Fax: 914-763-2519
Mailing address:
  • Phone: 201-947-4008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number225229-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: