MEDICARE: CLADIMAR VASQUEZ 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
1	207RI0200X	Infectious Disease Physician	325179-01	NY
2	207RI0200X	Infectious Disease Physician	111549	GA

General Provider Information

NPI Number	:	1932786498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLADIMAR VASQUEZ MD

Provider Business Mailing Address
First Line	:	622 W 168TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3720
Country	:	US
Telephone Number	:	347-463-5029
Fax Number	:

Provider Business Practice Location Address
First Line	:	1468 MADISON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6508
Country	:	US
Telephone Number	:	212-241-6500
Fax Number	:

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

Provider Enumeration Date	:	03/29/2021
Last Update Date	:	06/05/2026

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Directions to “ CLADIMAR VASQUEZ MD” Practice Location

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