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NPI Code Detail

MEDICARE: SERGEY AYZENBERG M.D

MEDICARE: SERGEY AYZENBERG 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
1207RI0011XInterventional Cardiology Physician236793NY
2207RC0000XCardiovascular Disease Physician236793NY

General Provider Information

NPI Number : 1306031125
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERGEY AYZENBERG M.D
Provider Business Mailing Address
First Line : 4802 10TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2916
Country : US
Telephone Number : 718-283-7489
Fax Number :
Provider Business Practice Location Address
First Line : 4802 10TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2916
Country : US
Telephone Number : 718-283-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2007
Last Update Date : 01/16/2026

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