Healthcare Provider Details
I. General information
NPI: 1851606966
Provider Name (Legal Business Name): VIKAS TANEJA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/12/2010
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1945 STATE ROUTE 33
NEPTUNE NJ
07753-4859
US
IV. Provider business mailing address
331 NEWMAN SPRINGS RD BLDG 2, STE 220
RED BANK NJ
07701-5688
US
V. Phone/Fax
- Phone: 732-897-2770
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME120175 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 4301096755 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | 25MA12570700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: