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NPI Code Detail

MEDICARE: DR. VIJAYA R DASIKA M.D.

MEDICARE:  DR. VIJAYA R DASIKA  M.D.
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
12084N0400XNeurology PhysicianNJ

General Provider Information

NPI Number : 1780625541
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIJAYA R DASIKA M.D.
Provider Business Mailing Address
First Line : 9245 KENNEDY BLVD
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-5322
Country : US
Telephone Number : 201-868-2311
Fax Number : 201-868-9292
Provider Business Practice Location Address
First Line : 9245 KENNEDY BLVD
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-5322
Country : US
Telephone Number : 201-868-2311
Fax Number : 201-868-9292
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2006
Last Update Date : 07/08/2007

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Directions to “ DR. VIJAYA R DASIKA M.D.” Practice Location

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