Provider Demographics
NPI:1598935611
Name:VINOVRSKI, TODD J (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:J
Last Name:VINOVRSKI
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 1:462 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-9998
Mailing Address - Country:US
Mailing Address - Phone:508-235-1118
Mailing Address - Fax:
Practice Address - Street 1:1822 N MAIN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-1318
Practice Address - Country:US
Practice Address - Phone:508-235-1118
Practice Address - Fax:508-235-1119
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD12593207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA167844ZE7MMedicare PIN