Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 25MA10348400 | NJ |
NPI | 1073747705 |
---|---|
Provider Name | Vikalp Jain |
First Address | Brick, NJ 08724-7732 |
Second Address | Brick, NJ 08724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2009 |
Last Update Date | 24/08/2018 |