Vault Medical Group PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VAULT MEDICAL GROUP PA

Doing business as

Vault Medical Services PA

Practice address

133 E 58TH St Ste 512
New York, NY 10022-1145

Phone

(212) 880-5494

NPI assigned

Aug 31, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Alexander Wojciech Pastuszak, MD

Title

Chief Clinical Officer

Phone

(415) 412-2934

Specialties & licenses 1

Addresses

Other names 1

• Vault Medical Services PA Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600387200000",
    "number": "1295348019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 5TH AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033019",
            "telephone_number": "212-880-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST STE 512",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221145",
            "telephone_number": "212-880-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAULT MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "PASTUSZAK",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "WOJCIECH",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "415-412-2934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vault Medical Services PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Timothy Vaughn, O.D.
• Megan Christine Vaughn
• Rubiahna Vaughn, MD, MPH
• Whitney Elizabeth Vaughn, PA-C
• David M Vaughns, LCSW, MA
• Linnea Vaurio, PH.D.
• Harner Gerard Vaval, MSW
• Diana Vavikova, DC
• Nataliya Vavrynchuk, MD
• Shari Ellen Vayda, MA, OTR/L

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.