Provider Demographics
NPI:1912196080
Name:VASADIA, VIJAYSING A (PA)
Entity Type:Individual
Prefix:
First Name:VIJAYSING
Middle Name:A
Last Name:VASADIA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3255 E ELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-7256
Mailing Address - Country:US
Mailing Address - Phone:602-470-5043
Mailing Address - Fax:602-470-5064
Practice Address - Street 1:2601 E ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4973
Practice Address - Country:US
Practice Address - Phone:602-344-5608
Practice Address - Fax:602-344-1299
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2007-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3690363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant