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Organization
MEDINOVA PHYSICIANS PLLC
Active
Organization
MEDINOVA PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY K ALLA (MD)
(718) 665-0223
Entity
Organization
Contact information
Practice address
814 E 156TH ST, BRONX, NY 10455-1714
(718) 665-0223
Mailing address
814 E. 156 STREET, BRONX, NY 10455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
211607
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211607
STATE LICENSE NUMBER
NY
Enumeration date
12/08/2008
Last updated
09/14/2011
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