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NPI Code Detail

MEDICARE: JAYANDRA VIGNARAJAH MD

MEDICARE: JAYANDRA VIGNARAJAH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician294862NY

General Provider Information

NPI Number : 1578948527
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAYANDRA VIGNARAJAH MD
Provider Business Mailing Address
First Line : 301 PROSPECT AVE
Second Line :
City : SYRACUSE
State : NY
Zip : 13203-1807
Country : US
Telephone Number : 315-448-5536
Fax Number :
Provider Business Practice Location Address
First Line : 301 PROSPECT AVE
Second Line :
City : SYRACUSE
State : NY
Zip : 13203-1807
Country : US
Telephone Number : 315-448-5536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2015
Last Update Date : 05/20/2026

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