Organization
MODERN GASTROENTEROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KONSTANTIN VAIZMAN MD (MEDICAL DIRECTOR)
(347) 446-6839
Entity
Organization
Contact information
Practice address
2705 MERMAID AVE, BROOKLYN, NY 11224-2005
(718) 265-2222
(718) 333-1023
Mailing address
947 79TH ST, STE 1, BROOKLYN, NY 11228-2613
(347) 446-6839
(718) 333-1023
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
09/20/2014
Last updated
09/20/2014
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