Individual
VIVEK V. GUMASTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(347) 671-8225
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(347) 671-8225
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
164379
NY
207RG0100X
Gastroenterology Physician
Primary
164379
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01027307
—
NY
Enumeration date
07/27/2006
Last updated
12/06/2013
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