Provider Demographics
NPI:1194868919
Name:BAJAJ, NEIL (OD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:BAJAJ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5020 W SAGINAW HWY
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-2625
Mailing Address - Country:US
Mailing Address - Phone:517-321-7644
Mailing Address - Fax:517-321-7690
Practice Address - Street 1:5020 W SAGINAW HWY
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-2625
Practice Address - Country:US
Practice Address - Phone:517-321-7644
Practice Address - Fax:517-321-7690
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004279152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist