Provider Demographics
NPI:1285264457
Name:VABISHCHEVICH, GREGORY (RRT)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:VABISHCHEVICH
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:13479-0405
Mailing Address - Country:US
Mailing Address - Phone:315-725-2184
Mailing Address - Fax:
Practice Address - Street 1:3985 ONEIDA ST STE 102
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-9733
Practice Address - Country:US
Practice Address - Phone:315-725-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010201332BX2000X, 2278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies