Nimmy Vadakat, | |
2196a White Plains Rd, Bronx, NY 10462-1406 | |
(718) 513-3577 | |
Not Available |
Full Name | Nimmy Vadakat |
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Gender | Female |
Speciality | Optometrist |
Location | 2196a White Plains Rd, Bronx, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902496235 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | TUV009263 (New York) | Primary |
Provider Name | Designer Optical Of Plains Parkway Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1962009175 PECOS PAC ID: 7618385808 Enrollment ID: O20210428002014 |
Mailing Address | Practice Location Address |
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Nimmy Vadakat, 2196a White Plains Rd, Bronx, NY 10462-1406 Ph: () - | Nimmy Vadakat, 2196a White Plains Rd, Bronx, NY 10462-1406 Ph: (718) 513-3577 |
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