Provider Demographics
NPI:1952491698
Name:KAPOOR, VINAY (MD)
Entity Type:Individual
Prefix:DR
First Name:VINAY
Middle Name:
Last Name:KAPOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VINAY
Other - Middle Name:
Other - Last Name:KAPOOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:22215 NORTHERN BLVD
Mailing Address - Street 2:STE. LL-B
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3603
Mailing Address - Country:US
Mailing Address - Phone:718-279-4005
Mailing Address - Fax:718-279-4413
Practice Address - Street 1:22215 NORTHERN BLVD
Practice Address - Street 2:STE. LL-B
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3603
Practice Address - Country:US
Practice Address - Phone:718-279-4005
Practice Address - Fax:718-279-4413
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160458207R00000X, 207RA0000X, 207RE0101X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000082704OtherGHI HMO
NY0078521OtherGHI PPO
NY01124854Medicaid
NY12396POtherHIP
NY0538972022OtherCIGNA
NY4462972OtherAETNA
NYDP364OtherOXFORD
NY84D751OtherBC/BS
NYNZ1792OtherHEALTHNET
NY168684OtherELDERPLAN
NY82704OtherGHI MEDICARE
NY4462972OtherAETNA
NYDP364OtherOXFORD