Individual provider · NPI-1

Dr. Vijayakumar Alla, M.D

Internal Medicine · Astoria, NY

NPI number1598748592
StatusActive
Last updated in NPPESJun 26, 2020

Details

NPI
1598748592
Entity type
Individual (NPI-1)
Name
Dr. Vijayakumar Alla
Credential
M.D
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 22, 2005
Certification date
Jun 26, 2020
Last updated
Jun 26, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine211067NYYes

Other names

  • Vijayakumar Alla (Former Name)

Practice location

2802 Crescent St
Astoria, NY 11102-3141

Phone 718-278-6666

Mailing address

814 E 156th St
Bronx, NY 10455-1714

Phone 718-665-0223

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