Healthcare Provider Details

I. General information

NPI: 1841508421
Provider Name (Legal Business Name): VIKAS MALIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 COURT ST SUITE 816
BROOKLYN NY
11242
US

IV. Provider business mailing address

26 COURT ST SUITE 816
BROOKLYN NY
11242-0103
US

V. Phone/Fax

Practice location:
  • Phone: 347-987-4233
  • Fax:
Mailing address:
  • Phone: 347-987-4233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number247384
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number285676
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: