Individual
VIJAYAN A MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
936 DELAWARE AVE, SUITE 100, BUFFALO, NY 14209-1804
(716) 885-5437
Mailing address
7 HEMLOCK HILL RD, ORCHARD PARK, NY 14127-3965
(716) 662-2658
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
113940
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010117402
UNIVERA
NY
01
—
000506120006
COMMUNITY BLUE
NY
05
—
00631003
—
NY
01
—
5061203
FIDELIS
NY
01
—
5300456
INDEPENDENT HEALTH
NY
Enumeration date
12/31/2006
Last updated
07/09/2007
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