Provider Demographics
NPI:1528167186
Name:ANAND, VIJAY K (MD)
Entity type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:K
Last Name:ANAND
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 1:772 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4153
Mailing Address - Country:US
Mailing Address - Phone:212-452-3005
Mailing Address - Fax:212-452-3660
Practice Address - Street 1:772 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4153
Practice Address - Country:US
Practice Address - Phone:212-452-3005
Practice Address - Fax:212-452-3660
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1453501174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64912Medicare UPIN