Provider Demographics
NPI:1174515753
Name:VIROJA, YOGESH (MD)
Entity type:Individual
Prefix:
First Name:YOGESH
Middle Name:
Last Name:VIROJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 MEMORIAL PKWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2748
Mailing Address - Country:US
Mailing Address - Phone:908-859-4446
Mailing Address - Fax:908-859-1569
Practice Address - Street 1:755 MEMORIAL PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2748
Practice Address - Country:US
Practice Address - Phone:908-859-4446
Practice Address - Fax:908-859-1569
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
NJMA49494207R00000X
PAMD039713L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC54558Medicare UPIN
NJ850473Medicare ID - Type Unspecified
PA850669Medicare ID - Type Unspecified