Healthcare Provider Details

I. General information

NPI: 1336195510
Provider Name (Legal Business Name): VINNY ANAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 PROSPECT AVE SUITE 210
HUDSON NY
12534-2907
US

IV. Provider business mailing address

67 PROSPECT AVE SUITE 210
HUDSON NY
12534-2907
US

V. Phone/Fax

Practice location:
  • Phone: 518-828-2566
  • Fax:
Mailing address:
  • Phone: 518-828-2566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number1-174389
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier110437
Identifier TypeOTHER
Identifier State
Identifier IssuerWELLCARE
# 2
Identifier040426007322
Identifier TypeOTHER
Identifier State
Identifier IssuerFIDELIS
# 3
Identifier01248282
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 4
Identifier10437
Identifier TypeOTHER
Identifier State
Identifier IssuerGHI HMO
# 5
Identifier805882
Identifier TypeOTHER
Identifier State
Identifier IssuerBC/BS
# 6
Identifier897599
Identifier TypeOTHER
Identifier State
Identifier IssuerUNITED HEALTHCARE
# 7
IdentifierP902869
Identifier TypeOTHER
Identifier State
Identifier IssuerOXFORD
# 8
Identifier000401435002
Identifier TypeOTHER
Identifier State
Identifier IssuerBS OF NENY
# 9
Identifier990832
Identifier TypeOTHER
Identifier State
Identifier IssuerMVP
# 10
Identifier10000041
Identifier TypeOTHER
Identifier State
Identifier IssuerCDPHP
# 11
Identifier6007810
Identifier TypeOTHER
Identifier State
Identifier IssuerGHI PPO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: