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NPI Code Detail

MEDICARE: NEHA MADHIWALA OD

MEDICARE: NEHA MADHIWALA OD
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
1152W00000XOptometrist27OA00606300NJ

General Provider Information

NPI Number : 1215005707
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEHA MADHIWALA OD
Provider Business Mailing Address
First Line : 11103 WEST AVE
Second Line : SUITE 6
City : SAN ANTONIO
State : TX
Zip : 78213-1370
Country : US
Telephone Number : 210-524-6509
Fax Number : 210-524-6587
Provider Business Practice Location Address
First Line : 251 CLIFTON AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07011-1961
Country : US
Telephone Number : 973-340-2300
Fax Number : 973-340-2306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 05/26/2021

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Directions to “ NEHA MADHIWALA OD” Practice Location

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