Provider Demographics
NPI:1356318950
Name:VINGAN, ROY D (MD)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:D
Last Name:VINGAN
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 1:650 FROM RD STE 220
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3551
Mailing Address - Country:US
Mailing Address - Phone:201-342-2550
Mailing Address - Fax:201-342-7171
Practice Address - Street 1:650 FROM RD STE 220
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3551
Practice Address - Country:US
Practice Address - Phone:201-342-2550
Practice Address - Fax:201-342-7171
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05763900207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF23393Medicare UPIN