Provider Demographics
NPI:1730283474
Name:VAD, VIJAY B (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:B
Last Name:VAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:535 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4872
Mailing Address - Country:US
Mailing Address - Phone:212-606-1306
Mailing Address - Fax:212-774-2934
Practice Address - Street 1:519 E 72ND ST
Practice Address - Street 2:203
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4028
Practice Address - Country:US
Practice Address - Phone:212-606-1306
Practice Address - Fax:212-774-2934
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199068-12081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1730283474OtherNONE PARTICIPATING HEALTH CARE PROVIDER
NYN 80095OtherHEALTH NET
NYP1947763OtherOXFORD
NYG47720Medicare UPIN