Provider Demographics
NPI:1750674727
Name:NIJJAR, GAGAN VIRK (MD)
Entity Type:Individual
Prefix:DR
First Name:GAGAN
Middle Name:VIRK
Last Name:NIJJAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5990 RICHMOND HWY
Mailing Address - Street 2:APT 709
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-2745
Mailing Address - Country:US
Mailing Address - Phone:619-632-7364
Mailing Address - Fax:
Practice Address - Street 1:1100 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4540
Practice Address - Country:US
Practice Address - Phone:202-407-2116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1132712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry