Vagabonding Through the Ether

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

MD451221 Issued in PA

Legal business name

VAGABONDING THROUGH THE ETHER

Doing business as

Vagabonding Through The Ether

Practice address

1300 Horizon Dr Ste 101
Chalfont, PA 18914-3970

Phone

(267) 225-4759

NPI assigned

Dec 21, 2016

Last updated

Jan 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Grodofsky, MD

Title

Owner

Phone

(267) 225-4759

Specialties & licenses 2

Addresses

Other names 1

• Vagabonding Through The Ether Doing business as

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1437694809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 HORIZON DR STE 101",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143970",
            "telephone_number": "267-225-4759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HORIZON DR STE 101",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143970",
            "telephone_number": "267-225-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAGABONDING THROUGH THE ETHER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "GRODOFSKY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-225-4759",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD451221",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PA",
            "license": "MD451221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vagabonding Through The Ether",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Interventional Pain Medicine Physician in Chalfont, PA
• Providers in Chalfont, PA by specialty
• Interventional Pain Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.