Provider Demographics
NPI:1952781650
Name:VAISMAN MEDICAL SERVICES PLLC
Entity Type:Organization
Organization Name:VAISMAN MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:VAISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-608-8650
Mailing Address - Street 1:5685 BUENA MARTINA WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-7104
Mailing Address - Country:US
Mailing Address - Phone:917-608-8650
Mailing Address - Fax:
Practice Address - Street 1:5685 BUENA MARTINA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-7104
Practice Address - Country:US
Practice Address - Phone:917-608-8650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1374207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty