VITALY VAVRINYUK RN
NPI 1942807003
Registered Nurse - Pediatrics in Ithaca, NY
Active since October 02, 2020
About Vitaly Vavrinyuk Rn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VITALY VAVRINYUK RN (NPI 1942807003) is an individual pediatrics provider in Ithaca, New York, licensed in New York (746036) and active in the NPI registry since October 2020.
NPPES Registry Identity
NPI1942807003
Entity TypeIndividualMale
Primary Taxonomy163WP0200X
Provider Legal NameVITALY VAVRINYUKCredential: RN
Location Address300 WEST AVEIthaca, NY 14853-6002
Mailing Address121 Veterans Pl Unit E-104Ithaca, NY 14850-6900 · (253) 306-2691
Phone(607) 254-4636
Sole ProprietorYes
Enumeration DateOctober 2, 2020
NPPES CertifiedOctober 1, 2020
✔ NPI 1942807003 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyRegistered Nurse · PediatricsNursing Service Providers
Taxonomy Code163WP0200X
License✔ Licensed in NY · 746036
300 WEST AVE, Ithaca, NY 14853
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942807003, enumerated as an "individual" on October 02, 2020.
The provider is located at 300 WEST AVE ITHACA, NY 14853 and the phone number is (607) 254-4636.
Registered Nurse with taxonomy code 163WP0200X and a focus in Pediatrics.
