Provider Demographics
NPI:1013914167
Name:SIKAND, VIJAY K (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:K
Last Name:SIKAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 HERITAGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1109
Mailing Address - Country:US
Mailing Address - Phone:860-443-7907
Mailing Address - Fax:860-442-6730
Practice Address - Street 1:37 CAMP MOWEEN RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:CT
Practice Address - Zip Code:06249-2704
Practice Address - Country:US
Practice Address - Phone:860-443-7907
Practice Address - Fax:860-442-6730
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026526207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001365263Medicaid
CT080000894Medicare ID - Type Unspecified
CT001365263Medicaid