Provider Demographics
NPI:1679375299
Name:VJ 96 LLC
Entity type:Organization
Organization Name:VJ 96 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:JAGDEEP
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:WANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-397-5718
Mailing Address - Street 1:400 E BURWELL ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-4329
Mailing Address - Country:US
Mailing Address - Phone:540-387-3105
Mailing Address - Fax:540-387-3653
Practice Address - Street 1:400 E BURWELL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-4329
Practice Address - Country:US
Practice Address - Phone:540-387-3105
Practice Address - Fax:540-387-3653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty