ENVIRONMENTAL HEALTH CENTER OF MARTHA'S VINEYARD – NPI #1275894875
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

ENVIRONMENTAL HEALTH CENTER OF MARTHA'S VINEYARD is a provider located in WEST TISBURY, MA. NPPES has assigned the NPI number 1275894875 to ENVIRONMENTAL HEALTH CENTER OF MARTHA'S VINEYARD on May 31, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ENVIRONMENTAL HEALTH CENTER OF MARTHA'S VINEYARD” is a dba name, the actual legal business name for this organization is VINEYARD PERSONALIZED MEDICINE LLC. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 11 years ago on Nov 25, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ENVIRONMENTAL HEALTH CENTER OF MARTHA'S VINEYARD below.

NPI Profile for
VINEYARD PERSONALIZED MEDICINE LLC

NPI Number
1275894875
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
VINEYARD PERSONALIZED MEDICINE LLC
Doing Business As (dba): ENVIRONMENTAL HEALTH CENTER OF MARTHA'S VINEYARD
Primary location
24 COURNOYER RD
WEST TISBURY, MA 02575
Phone: (508) 693-1300 Fax: (508) 693-1305
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
LISA NAGY
SOLE PROPRIETOR
Phone: (508) 693-1300
Updated
Identifiers

Identifiers for ENVIRONMENTAL HEALTH CENTER OF MARTHA'S VINEYARD

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMA11009334A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)
MA 72590

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.