Provider Demographics
NPI:1275617235
Name:VOGEL PEDIATRICS INC
Entity Type:Organization
Organization Name:VOGEL PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-490-3331
Mailing Address - Street 1:4624 PEMBROKE BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455
Mailing Address - Country:US
Mailing Address - Phone:757-490-3331
Mailing Address - Fax:757-490-3055
Practice Address - Street 1:4624 PEMBROKE BLVD
Practice Address - Street 2:STE 101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455
Practice Address - Country:US
Practice Address - Phone:757-490-3331
Practice Address - Fax:757-490-3055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherTAX ID #