Healthcare Provider Details

I. General information

NPI: 1316255730
Provider Name (Legal Business Name): PAARI VIJAYARAGAVAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

601 ELMWOOD AVENUE BOX SURG TRANSPLANT BOX SURG
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

18, RAJU NAIDU STREET-II, GANAPATHY
COIMBATORE TAMIL NADU
641006
IN

V. Phone/Fax

Practice location:
  • Phone: 585-275-5875
  • Fax: 585-271-7929
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberP77031
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: