Provider Demographics
NPI:1023321056
Name:VACHHANI, ANJALI DESAI (OD)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:DESAI
Last Name:VACHHANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 DAVIS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6008
Mailing Address - Country:US
Mailing Address - Phone:919-234-4888
Mailing Address - Fax:919-234-4890
Practice Address - Street 1:3603 DAVIS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6008
Practice Address - Country:US
Practice Address - Phone:919-234-4888
Practice Address - Fax:919-234-4890
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002339152W00000X
NC2221152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist