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NPI Code Detail

MEDICARE: RIA VIJ

MEDICARE: RIA VIJ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry30.027794OH
2390200000XStudent in an Organized Health Care Education/Training Program
31223P0221XPediatric Dentistry30.027794OH

General Provider Information

NPI Number : 1902596000
Entity Type Code : Individual
Provider Name (Legal Business Name) : RIA VIJ
Provider Business Mailing Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number : 330-338-0330
Fax Number :
Provider Business Practice Location Address
First Line : 3523 COMMERCIAL DR
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-5107
Country : US
Telephone Number : 330-668-9977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2023
Last Update Date : 07/15/2025

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Directions to “ RIA VIJ ” Practice Location

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