DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MODERN GASTROENTEROLOGY PC

MEDICARE: MODERN GASTROENTEROLOGY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1578965638
Entity Type Code : Organization
Provider Name (Legal Business Name) : MODERN GASTROENTEROLOGY PC
Provider Business Mailing Address
First Line : 947 79TH ST
Second Line : STE 1
City : BROOKLYN
State : NY
Zip : 11228-2613
Country : US
Telephone Number : 347-446-6839
Fax Number : 718-333-1023
Provider Business Practice Location Address
First Line : 2705 MERMAID AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11224-2005
Country : US
Telephone Number : 718-265-2222
Fax Number : 718-333-1023
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : KONSTANTIN VAIZMAN
Credential : MD
Telephone Number : 347-446-6839
Provider Enumeration Date : 09/20/2014
Last Update Date : 09/20/2014

Similar Medicare Providers

1720016793 — DR. MICHAEL TAVDY M.D.
Practice Location Address:
2705 MERMAID AVE
BROOKLYN, NY
11224-2005
Practice Phone: 718-265-2222
Practice Fax: 718-333-1023
1073529731 — OLEG LATVINSKY DPM
Practice Location Address:
2705 MERMAID AVE
BROOKLYN, NY
11224-2005
Practice Phone: 718-265-2222
Practice Fax: 718-333-1023
1639246150 — SOUTH BROOKLYN MEDICAL CARE, PC
Practice Location Address:
2705 MERMAID AVE
BROOKLYN, NY
11224-2005
Practice Phone: 718-265-2222
Practice Fax: 718-333-1023
1902012628 — MARGARITA RITA JOSIPOVICH RD
Practice Location Address:
2705 MERMAID AVE
BROOKLYN, NY
11224-2005
Practice Phone: 171-826-5222
Practice Fax:
1699074690 — JENNY THALAPPILLIL FNP
Practice Location Address:
2711 MERMAID AVE
BROOKLYN, NY
11224-2005
Practice Phone: 718-758-5952
Practice Fax:
1982978409 — AN MEDICAL NY PLLC
Practice Location Address:
2705 MERMAID AVE
BROOKLYN, NY
11224-2005
Practice Phone: 718-265-2222
Practice Fax:

Directions to “MODERN GASTROENTEROLOGY PC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.