Vineyard Personalized Medicine LLC

NPI #1275894875 in West Tisbury, Massachusetts

Provider Information

NPI Number: 1275894875
Entity Type: Organization
Organization Name: Vineyard Personalized Medicine LLC
Primary Specialty: General Practice
Enumeration Date: May 31, 2012
Last Updated: Nov 25, 2015

Practice Location

Address: 24 COURNOYER RD
City: West Tisbury
State: Massachusetts
ZIP Code: 02575
Phone: (508) 693-1300

Authorized Official

Name: LISA NAGY, MD
Title: SOLE PROPRIETOR
Phone: (508) 693-1300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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