Provider Demographics
NPI:1184170151
Name:VIJAY, ADITI (PHD)
Entity type:Individual
Prefix:DR
First Name:ADITI
Middle Name:
Last Name:VIJAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 WILLARD AVE
Mailing Address - Street 2:#2419S
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3622
Mailing Address - Country:US
Mailing Address - Phone:775-343-6259
Mailing Address - Fax:
Practice Address - Street 1:4933 AUBURN AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2631
Practice Address - Country:US
Practice Address - Phone:301-229-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1001182103TC0700X
MD05532103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical