MEDICARE: MODERN VEIN PROVIDERS, PLLC

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	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1346010527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MODERN VEIN PROVIDERS, PLLC

Provider Business Mailing Address
First Line	:	903 HARTFORD TPKE
Second Line	:
City	:	WATERFORD
State	:	CT
Zip	:	06385-4264
Country	:	US
Telephone Number	:	860-574-3423
Fax Number	:	860-222-9082

Provider Business Practice Location Address
First Line	:	903 HARTFORD TPKE
Second Line	:
City	:	WATERFORD
State	:	CT
Zip	:	06385-4264
Country	:	US
Telephone Number	:	860-574-3423
Fax Number	:	860-222-9082

Authorized Official
Title or Position	:	DOCTOR
Name	:	JIYONG AHN
Credential	:	MD
Telephone Number	:	860-574-3423

Provider Enumeration Date	:	01/08/2024
Last Update Date	:	01/08/2024

Similar Medicare Providers

1336781236 — WATERFORD VASCULAR ASSOCIATES, P.C.
Practice Location Address:

903 HARTFORD TPKE UNIT 30
WATERFORD, CT
06385-4264

Practice Phone: 860-772-1998
Practice Fax: 860-772-1999

1316704851 — WATERFORD EYECARE
Practice Location Address:

903 HARTFORD TPKE # 915
WATERFORD, CT
06385-4264

Practice Phone: 917-698-1292
Practice Fax:

1154174589 — WATERFORD OPTOMETRIC PC
Practice Location Address:

903 HARTFORD TPKE UNIT 29
WATERFORD, CT
06385-4264

Practice Phone: 917-698-1292
Practice Fax:

1619139961 — MRS. JULIA BETH SCHROEDER OTR
Practice Location Address:

400 PRAIRIE HILL WAY
WATERFORD, WI
53185-4264

Practice Phone: 262-763-9531
Practice Fax:

1013667633 — COMMUNITY BIRTH GROUP
Practice Location Address:

9558 DONATION RD
WATERFORD, PA
16441-4264

Practice Phone: 800-341-8598
Practice Fax: 866-399-0991

1659021277 — PRIVATE HEALTHCARE FACILITIES
Practice Location Address:

9558 DONATION RD
WATERFORD, PA
16441-4264

Practice Phone: 866-996-2340
Practice Fax: 866-399-0991

Directions to “MODERN VEIN PROVIDERS, PLLC ” 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.