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Kevin Marshall Vinik, PA-C

Physician Assistant in Worcester, MA. Individual provider (NPI-1).

NPI number1760905723
StatusActive
Last updated in NPPESOct 23, 2020

Details

NPI
1760905723
Entity type
Individual (NPI-1)
Name
Mr. Kevin Marshall Vinik
Credential
PA-C
Sex
Male
Sole proprietor
No
Enumeration date
Jul 21, 2017
Certification date
Oct 23, 2020
Last updated
Oct 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPA6187MAYes

Practice location

55 Lake Ave N
Worcester, MA 01655-0002

Phone 508-856-4161 · Fax 508-856-6703

Mailing address

Po Box 415348
Boston, MA 02241-5348

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