Provider Demographics
NPI:1518954080
Name:MAGGIO, VIJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:
Last Name:MAGGIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VIJAY
Other - Middle Name:
Other - Last Name:MAGGIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3 BRETWOOD DR N
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-2404
Mailing Address - Country:US
Mailing Address - Phone:888-464-2466
Mailing Address - Fax:410-740-1518
Practice Address - Street 1:3 BRETWOOD DR N
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2404
Practice Address - Country:US
Practice Address - Phone:888-464-2466
Practice Address - Fax:410-740-1518
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000442952084N0400X
IA381292084N0400X
NJ25MA083644002084N0400X
WI524752084N0400X
MN13092084N0400X
NC2004001422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG97676Medicare UPIN
NJ168935Medicare PIN