MEDICARE: ADRIENNE VINCENZINO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MA11154300	NJ
2	207R00000X	Internal Medicine Physician	220139	NY

General Provider Information

NPI Number	:	1225009954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE VINCENZINO MD

Provider Business Mailing Address
First Line	:	331 NEWMAN SPRINGS RD STE 220
Second Line	:
City	:	RED BANK
State	:	NJ
Zip	:	07701-5792
Country	:	US
Telephone Number	:	732-807-0877
Fax Number	:	201-751-1680

Provider Business Practice Location Address
First Line	:	4 HUNTER ST STE 203
Second Line	:
City	:	LODI
State	:	NJ
Zip	:	07644-1608
Country	:	US
Telephone Number	:	551-996-9100
Fax Number	:	551-996-9109

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	04/15/2026

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Directions to “ ADRIENNE VINCENZINO MD” Practice Location

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