Provider Demographics
NPI:1760833172
Name:VADIM FITNESS STUDIO, LTD
Entity Type:Organization
Organization Name:VADIM FITNESS STUDIO, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VILENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-725-9553
Mailing Address - Street 1:455 CENTRAL PARK AVE
Mailing Address - Street 2:455 CENTRAL PARK AVENUE
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1060
Mailing Address - Country:US
Mailing Address - Phone:914-725-9553
Mailing Address - Fax:914-725-4260
Practice Address - Street 1:455 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1060
Practice Address - Country:US
Practice Address - Phone:914-725-9553
Practice Address - Fax:914-725-4260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Single Specialty