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NPI Code Detail

MEDICARE: VANGUARD GASTROENTEROLOGY LLP

MEDICARE: VANGUARD GASTROENTEROLOGY LLP
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 : 1720639388
Entity Type Code : Organization
Provider Name (Legal Business Name) : VANGUARD GASTROENTEROLOGY LLP
Provider Business Mailing Address
First Line : 232 E 30TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10016-8202
Country : US
Telephone Number : 212-725-6768
Fax Number :
Provider Business Practice Location Address
First Line : 233 BROADWAY RM 2750
Second Line :
City : NEW YORK
State : NY
Zip : 10279-2704
Country : US
Telephone Number : 212-889-5544
Fax Number : 212-481-1089
Authorized Official
Title or Position : MANAGER
Name : ANGELA YAKUTILOVA
Credential :
Telephone Number : 212-889-5544
Provider Enumeration Date : 09/25/2019
Last Update Date : 07/13/2023

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Directions to “VANGUARD GASTROENTEROLOGY LLP ” Practice Location

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