Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 25MA10702700 | NJ |
N | 204F00000X | Transplant Surgeon | 268947 | NY |
N | 208200000X | Surgeon | 268947 | NY |
N | 208600000X | Surgeon | 268947 | NY |
NPI | 1225288830 |
---|---|
Provider Name | Dr. Vikram Wadhera |
First Address | Hackensack, NJ 07601-1941 |
Second Address | Hackensack, NJ 07601-1941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2008 |
Last Update Date | 27/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03712365 | (05) | NY |
0521116 | (05) | NJ |