Provider Demographics
NPI:1205168499
Name:VINOD V PATHY MD LLC
Entity type:Organization
Organization Name:VINOD V PATHY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:
Authorized Official - Last Name:PATHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-672-2824
Mailing Address - Street 1:1525 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498-2044
Mailing Address - Country:US
Mailing Address - Phone:718-672-2824
Mailing Address - Fax:718-672-4251
Practice Address - Street 1:1525 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-2044
Practice Address - Country:US
Practice Address - Phone:718-672-2824
Practice Address - Fax:718-672-4251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0456072086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty