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General NPI Number Information
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NPI Number | 1144851791
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Entity Type | Organization
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Legal Business Name | VIJAYAKANTHAN PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 02/03/2020
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 800 TURNPIKE STREET SUITE 300
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City | NORTH ANDOVER
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State | MA
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Zip | 01845
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Country | US
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Telephone | 978-794-5511
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Fax | 978-685-1048
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Provider Business Mailing Address
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Address Line | 800 TURNPIKE STREET SUITE 300
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City | NORTH ANDOVER
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State | MA
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Zip | 01845
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Country | US
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Telephone | 978-794-5511
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Fax | 978-685-1048
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | DR. MARINA G. VIJAYAKANTHAN
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Credential | MD
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Telephone | 978-794-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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