Basic Information
Provider Information
NPI: 1851730790
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARYA
FirstName: VIKRAM
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
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Mailing Information
Address1: 4422 3RD AVE
Address2: DEPT OF INTERNAL MED MILLS3
City: BRONX
State: NY
PostalCode: 104572545
CountryCode: US
TelephoneNumber: 7189606202
FaxNumber: 7189603486
Practice Location
Address1: 4422 3RD AVE
Address2: DEPT OF INTERNAL MED MILLS3
City: BRONX
State: NY
PostalCode: 104572545
CountryCode: US
TelephoneNumber: 7189606202
FaxNumber: 7189603486
Other Information
ProviderEnumerationDate: 06/24/2013
LastUpdateDate: 06/28/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD458675PAY Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X036142786ILN Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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