Provider Demographics
NPI:1710615877
Name:TVCG PLY PLLC
Entity Type:Organization
Organization Name:TVCG PLY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GORIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-775-1984
Mailing Address - Street 1:100 CAMP ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3063
Mailing Address - Country:US
Mailing Address - Phone:508-775-1984
Mailing Address - Fax:508-790-1890
Practice Address - Street 1:40 INDUSTRIAL PARK RD STE 203
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4888
Practice Address - Country:US
Practice Address - Phone:508-356-6504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty