Healthcare Provider Details

I. General information

NPI: 1528209210
Provider Name (Legal Business Name): VINODH PILLAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SPRUCE ST
PHILADELPHIA PA
19107-6130
US

IV. Provider business mailing address

800 SPRUCE ST
PHILADELPHIA PA
19107-6130
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-3000
  • Fax: 215-829-7564
Mailing address:
  • Phone: 215-829-3000
  • Fax: 215-829-7564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD447698
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberMD447698
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: