MEDICARE: DR. YEFIM VAYNSHELBAUM M.D.

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
1	2085R0202X	Diagnostic Radiology Physician	161694	NY

General Provider Information

NPI Number	:	1255361283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YEFIM VAYNSHELBAUM M.D.

Provider Business Mailing Address
First Line	:	330 E 38TH ST
Second Line	:	APT 44J
City	:	NEW YORK
State	:	NY
Zip	:	10016-2759
Country	:	US
Telephone Number	:	212-697-4589
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 PARK AVE S
Second Line	:	SUITE 1103
City	:	NEW YORK
State	:	NY
Zip	:	10003-1503
Country	:	US
Telephone Number	:	212-674-0444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/09/2007

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