Provider Demographics
NPI:1033252036
Name:SANDEEP VIJAY MD LTD
Entity Type:Organization
Organization Name:SANDEEP VIJAY MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:VIJAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-256-3637
Mailing Address - Street 1:2251 N RAMPART BLVD
Mailing Address - Street 2:SUITE 127
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7640
Mailing Address - Country:US
Mailing Address - Phone:702-388-1300
Mailing Address - Fax:702-254-5631
Practice Address - Street 1:2251 N RAMPART BLVD
Practice Address - Street 2:SUITE 127
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7640
Practice Address - Country:US
Practice Address - Phone:702-256-3637
Practice Address - Fax:702-254-5631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1538202536OtherNPI INDIVIDUAL
1033252036OtherNPI GROUP
NVF89645Medicare UPIN
NV38580Medicare ID - Type Unspecified
NVV38578Medicare PIN