Provider Demographics
NPI:1033494620
Name:VILENSKY, VADIM
Entity Type:Individual
Prefix:
First Name:VADIM
Middle Name:
Last Name:VILENSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1068
Mailing Address - Country:US
Mailing Address - Phone:914-725-9553
Mailing Address - Fax:914-725-4260
Practice Address - Street 1:495 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1068
Practice Address - Country:US
Practice Address - Phone:914-725-9553
Practice Address - Fax:914-725-4260
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist