MEDICARE: DR. SIMI BHARDWAJ SETHI O.D.

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	1050-OD	WV
2	152W00000X	Optometrist	0618001603	VA
3	152W00000X	Optometrist	27OA006618800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144382946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMI BHARDWAJ SETHI O.D.

Provider Business Mailing Address
First Line	:	5 CRESTWOOD AVE
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1946
Country	:	US
Telephone Number	:	609-345-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 ATLANTIC AVE
Second Line	:	SAI VISION CARE LLC DBA FAMILY VISION CARE
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-8006
Country	:	US
Telephone Number	:	609-345-3000
Fax Number	:	609-345-1494

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

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	01/29/2020

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