Provider Demographics
NPI:1285616888
Name:KAJLA, VIJAY K (MD)
Entity type:Individual
Prefix:
First Name:VIJAY
Middle Name:K
Last Name:KAJLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-595-2000
Mailing Address - Fax:508-853-7149
Practice Address - Street 1:630 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-595-2000
Practice Address - Fax:508-853-7149
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209272207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherPRIVATE HEALTHCARE SYSTEM
5603502OtherAETNA US HEALTHCARE
AA5966OtherHARVARD PILGRIM HEALTHCAR
J23373OtherBLUE SHIELD INDEMNITY
042472266OtherTHREE RIVERS
J23373OtherBLUE CARE ELECT
042472266OtherHEALTHCARE VALUE MGMT
1601039OtherFIRST HEALTH
380001633OtherRAILROAD MEDICARE
A32547OtherMEDICARE B
49277OtherFALLON COMMUNITY HEALTH
0140481OtherHEALTHY START
0402313OtherEVERCARE
1574863OtherCIGNA HEALTH PLAN
784034OtherMVP HEALTH CARE
0140481OtherMEDICAID WELFARE
MA0140481Medicaid
J23372OtherBLUE SHIELD HMO BLUE
49277OtherFALLON COMMUNITY HEALTH
MAA32547Medicare ID - Type Unspecified