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General NPI Number Information
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NPI Number | 1659628154
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Entity Type | Individual
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Provider Name | VIJAY J NAYAK DO
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Gender | Male
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 4320 SEMINARY RD
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1535
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Country | US
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Telephone | 703-504-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 8001 FORBES PL STE 103
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City | SPRINGFIELD
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State | VA
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Zip | 22151-2205
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Country | US
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Telephone | 814-426-7319
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OP61678803
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 15425
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0102205709
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License Number State | VA
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