Provider Demographics
NPI:1316981558
Name:ALAGAPPAN, VYTHILINGAM (MD)
Entity type:Individual
Prefix:DR
First Name:VYTHILINGAM
Middle Name:
Last Name:ALAGAPPAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-1466
Mailing Address - Country:US
Mailing Address - Phone:585-678-6886
Mailing Address - Fax:585-625-0429
Practice Address - Street 1:3350 BROWN RD
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:NY
Practice Address - Zip Code:14423-9534
Practice Address - Country:US
Practice Address - Phone:585-678-6886
Practice Address - Fax:585-625-0429
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG52125Medicare UPIN
NYBB7078Medicare PIN