Provider Demographics
NPI:1013097229
Name:GIZDAVCIC, VESNA M (MD)
Entity Type:Individual
Prefix:
First Name:VESNA
Middle Name:M
Last Name:GIZDAVCIC
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 SEVENTH AVENUE
Mailing Address - Street 2:UNION HEALTH CENTER, INC.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:212-924-2510
Mailing Address - Fax:212-812-3614
Practice Address - Street 1:275 SEVENTH AVENUE
Practice Address - Street 2:UNION HEALTH CENTER, INC.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-924-2510
Practice Address - Fax:212-812-3614
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2014-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY170945207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF29656Medicare UPIN