National Provider Identifier
Vathasinlapa Dominik Vasavong, PA-C
Vathasinlapa Dominik Vasavong, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Rochester, NY and a listed phone number of (585) 723-7870.
Profile Overview
- NPI
- 1144959909
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- June 07, 2022
- Last Updated
- August 10, 2023
Practice Location
- 1555 Long Pond RD
- Rochester, NY 14626-4164
Phone: (585) 723-7870
Mailing Address
- 100 Kings Hwy S
- Rochester, NY 14617-5504
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1144959909
- Entity Type
- Individual
- Last Name
- Vasavong
- First Name
- Vathasinlapa
- Middle Name
- Dominik
- Credential
- PA-C
- Mailing Street Address
- 100 Kings Hwy S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-5504
- Mailing Country
- US
- Mailing Phone
- (585) 723-7870
- Practice Street Address
- 1555 Long Pond RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14626-4164
- Practice Country
- US
- Practice Phone
- (585) 723-7870
- Enumeration Date
- June 07, 2022
- Last Updated
- August 10, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- August 10, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)