Provider Demographics
NPI:1851658769
Name:VINELLI, MARK JR (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:VINELLI
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:975 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4816
Mailing Address - Country:US
Mailing Address - Phone:516-267-6854
Mailing Address - Fax:516-745-5479
Practice Address - Street 1:975 STEWART AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4816
Practice Address - Country:US
Practice Address - Phone:516-267-6854
Practice Address - Fax:516-745-5479
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276386207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine