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NPI Code Detail

MEDICARE: ANTHONY P VAVASIS MD

MEDICARE: ANTHONY P VAVASIS MD
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
1207Q00000XFamily Medicine Physician194759NY
2207RA0000XAdolescent Medicine (Internal Medicine) Physician194759NY

General Provider Information

NPI Number : 1396729984
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY P VAVASIS MD
Provider Business Mailing Address
First Line : 356 W 18TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10011-4401
Country : US
Telephone Number : 212-271-7200
Fax Number : 212-271-8111
Provider Business Practice Location Address
First Line : 265 ASHLAND PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-1661
Country : US
Telephone Number : 718-606-3863
Fax Number : 718-260-8630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 04/08/2025

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