Provider Demographics
NPI:1417367152
Name:VIGNENDRA ARIYARAJAH MD PLLC
Entity Type:Organization
Organization Name:VIGNENDRA ARIYARAJAH MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:VIGNENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIYARAJAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-694-7608
Mailing Address - Street 1:228 MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-2722
Mailing Address - Country:US
Mailing Address - Phone:267-694-7608
Mailing Address - Fax:813-329-0146
Practice Address - Street 1:228 MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-2722
Practice Address - Country:US
Practice Address - Phone:267-694-7608
Practice Address - Fax:813-329-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-03
Last Update Date:2014-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12205390174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty