MEDICARE: VJ ASSOCIATES PLLC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1942948070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VJ ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	4531 N 16TH ST STE 114
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-5344
Country	:	US
Telephone Number	:	602-274-0078
Fax Number	:	602-266-4477

Provider Business Practice Location Address
First Line	:	9494 E BECKER LN
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-6720
Country	:	US
Telephone Number	:	502-777-8556
Fax Number	:	502-777-0968

Authorized Official
Title or Position	:	OWNER
Name	:	VINAY PRABHAKARAN
Credential	:	MD
Telephone Number	:	520-777-8556

Provider Enumeration Date	:	05/27/2022
Last Update Date	:	05/27/2022

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