Provider Demographics
NPI:1164798617
Name:VIJAYAKANTHAN, MARINA GHAYATHRIE (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:GHAYATHRIE
Last Name:VIJAYAKANTHAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:218 EAST ROAD HAMPSTEAD HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841
Mailing Address - Country:US
Mailing Address - Phone:603-329-5311
Mailing Address - Fax:603-329-4746
Practice Address - Street 1:218 EAST ROAD HAMPSTEAD HOSPITAL
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841
Practice Address - Country:US
Practice Address - Phone:603-329-5311
Practice Address - Fax:603-329-4746
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH166532084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry