Provider Demographics
NPI:1467598755
Name:MALHOTRA, VIJAY K (MD)
Entity type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:K
Last Name:MALHOTRA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-357-7333
Mailing Address - Fax:724-357-7279
Practice Address - Street 1:374 THEATRE DR STE 2A
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3221
Practice Address - Country:US
Practice Address - Phone:814-535-6521
Practice Address - Fax:814-536-4819
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037404L207R00000X
PAMD037404-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104468912-0001Medicaid
PA0598845Medicaid
PAB35379Medicare UPIN