Individual
VICKRAM JAY TANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
476 JAMAICAWAY APT 2, JAMAICA PLAIN, MA 02130-2030
(510) 364-7494
Mailing address
476 JAMAICAWAY APT 2, JAMAICA PLAIN, MA 02130-2030
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
291776
MA
390200000X
Student in an Organized Health Care Education/Training Program
4301110334
MI
Other
Enumeration date
06/23/2016
Last updated
06/22/2022
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