Basic Information
Provider Information
NPI: 1710263470
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VIJ
FirstName: ABHINAV
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D., M.P.H.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 1ST AVE FL 3
Address2:  
City: NEW YORK
State: NY
PostalCode: 100163295
CountryCode: US
TelephoneNumber: 2122639531
FaxNumber:  
Practice Location
Address1: 660 1ST AVE FL 3
Address2:  
City: NEW YORK
State: NY
PostalCode: 10016
CountryCode: US
TelephoneNumber: 2122639531
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/26/2011
LastUpdateDate: 11/22/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X CTN Student, Health CareStudent in an Organized Health Care Education/Training Program 
2085R0202XR5335TXN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X301524NYY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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