Provider Demographics
NPI:1669837894
Name:PAWAR, VIJAYANAND
Entity Type:Individual
Prefix:MR
First Name:VIJAYANAND
Middle Name:
Last Name:PAWAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41238 ROBERTS AVE
Mailing Address - Street 2:APT 5
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4937
Mailing Address - Country:US
Mailing Address - Phone:415-417-5655
Mailing Address - Fax:
Practice Address - Street 1:41238 ROBERTS AVE
Practice Address - Street 2:APT 5
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-4937
Practice Address - Country:US
Practice Address - Phone:415-417-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist