Provider Demographics
NPI:1689848509
Name:VINAY R AGGARWAL MD, PLLC
Entity Type:Organization
Organization Name:VINAY R AGGARWAL MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:AGGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-637-9510
Mailing Address - Street 1:80 WEST AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-1322
Mailing Address - Country:US
Mailing Address - Phone:585-637-9510
Mailing Address - Fax:
Practice Address - Street 1:80 WEST AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-1322
Practice Address - Country:US
Practice Address - Phone:585-637-9510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0370Medicare PIN