Provider Demographics
NPI:1407954787
Name:SAINI, VIKAS (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKAS
Middle Name:
Last Name:SAINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5239
Mailing Address - Country:US
Mailing Address - Phone:617-732-1318
Mailing Address - Fax:617-734-5763
Practice Address - Street 1:21 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5239
Practice Address - Country:US
Practice Address - Phone:617-732-1318
Practice Address - Fax:617-734-5763
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53409174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3081974Medicaid
MA3081974Medicaid
A58692Medicare UPIN