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Organization
CONEY ISLAND MEDICAL DIAGNOSTIC SERVICES P C
Active
Organization
CONEY ISLAND MEDICAL DIAGNOSTIC SERVICES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KONSTANTIN VAIZMAN MD (OWNER)
(347) 446-6839
Entity
Organization
Contact information
Practice address
1704 MERMAID AVE STE 6, BROOKLYN, NY 11224-2622
(516) 567-5410
Mailing address
PO BOX 86, JERICHO, NY 11753-0086
(516) 567-5410
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Enumeration date
01/21/2020
Last updated
01/21/2020
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