Provider Demographics
NPI:1952308801
Name:FIRRINCIELI, VINCENT LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:LAWRENCE
Last Name:FIRRINCIELI
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:DEPT. 453 PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:2615 LAKE DR
Practice Address - Street 2:SUITE 301
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6693
Practice Address - Country:US
Practice Address - Phone:919-787-5995
Practice Address - Fax:919-783-9406
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300338207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCS118AOtherMEDICARE PTAN
NC1952308801Medicaid