Active NPI
Peter Vink, M.D.
- Pediatric Allergy/Immunology Physician
- Glenside, PA
National Provider Identifier
1376974139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Allergy/Immunology Physician
- License
- D0039091
- Practice address
- 610 Station Ave
Glenside, PA 19038-1421 - Phone
- (610) 787-3770
- NPI assigned
- Dec 4, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Allergy/Immunology Physician | 2080P0201X | D0039091 | MD | Primary |
Addresses
Primary practice location
610 Station Ave
Glenside, PA 19038-1421
Mailing address
610 Station Ave
Glenside, PA 19038-1421
Phone (610) 787-3770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0039091 | MD | MD | Pediatric Allergy/Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386115200000",
"number": "1376974139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 STATION AVE",
"city": "GLENSIDE",
"state": "PA",
"postal_code": "190381421",
"telephone_number": "610-787-3770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 STATION AVE",
"city": "GLENSIDE",
"state": "PA",
"postal_code": "190381421",
"telephone_number": "610-787-3770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINK",
"first_name": "PETER",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-04",
"last_updated": "2013-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0201X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Allergy/Immunology",
"state": "MD",
"license": "D0039091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenside, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.