Vaidhyanathan, Ketaki

Vaidhyanathan, Ketaki is an sole proprietor health care provider with primary practice located at 1 Bay Ave , Montclair NJ 07042-4837. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Vaidhyanathan, Ketaki can be contacted via phone (973) 429-6260.

Contact Information

Primary practice address
1 Bay Ave Montclair NJ 07042-4837
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 25MA08170600 New Jersey

Profile Details

NPI number 1992904445
LBN Legal business name Vaidhyanathan, Ketaki
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2007
Last updated Aug 3rd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992904445 NPPES
New Jersey MEDICAID 0232084

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