| Doctor Name: | PRITY S VAIDYA |
| NPI Number: | 1003874090 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 35058615 |
| Business Practice Address: | 295 Glessner Ave 3rd Fl Mansfield, OH - 449032270 |
| Business Phone Number: | 4195268044 |
| Business Fax Number: | 4195268854 |
| Mailing Address: | 295 Glessner Ave 3rd Fl, MANSFIELD |
| State: | OH |
| Postal Code: | 449032270 |
| Phone Number: | 4195268044 |
| Fax Number: | 4195268854 |
| NPI Enumeration Date: | 05/02/2006 |
| NPI Last Update Date: | 12/31/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WW0000X |
| License Number: | 35058615 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Wound Care |
| Taxonomy Definition: | |