Provider Demographics
NPI:1699751347
Name:ARYA, VIJAYPAL (MD)
Entity type:Individual
Prefix:
First Name:VIJAYPAL
Middle Name:
Last Name:ARYA
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 1:7517 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2638
Mailing Address - Country:US
Mailing Address - Phone:718-326-0400
Mailing Address - Fax:
Practice Address - Street 1:7517 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2638
Practice Address - Country:US
Practice Address - Phone:718-326-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187229207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01443636Medicaid
NY110195014Medicare PIN
NYF30357Medicare UPIN
NY07030GMedicare PIN
NY01443636Medicaid