Provider Demographics
NPI:1336195510
Name:ANAND, VINNY (MD)
Entity Type:Individual
Prefix:
First Name:VINNY
Middle Name:
Last Name:ANAND
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 1:67 PROSPECT AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2907
Mailing Address - Country:US
Mailing Address - Phone:518-828-2566
Mailing Address - Fax:
Practice Address - Street 1:67 PROSPECT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2907
Practice Address - Country:US
Practice Address - Phone:518-828-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-174389207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
110437OtherWELLCARE
040426007322OtherFIDELIS
NY01248282Medicaid
10437OtherGHI HMO
805882OtherBC/BS
897599OtherUNITED HEALTHCARE
P902869OtherOXFORD
000401435002OtherBS OF NENY
990832OtherMVP
10000041OtherCDPHP
6007810OtherGHI PPO
10000041OtherCDPHP
10437OtherGHI HMO
NYE94684Medicare UPIN
040426007322OtherFIDELIS