Organization · Type 2 NPI
Vascular Interventional Services, PLLC
Vascular Surgery Physician · Port Jefferson Sta, NY
NPI number
1144553025
Active
Practice location
1110B Hallock Ave
Port Jefferson Sta, NY 11776-1210
Fax (631) 476-4919
Mailing address
1110B Hallock Avenue
Port Jefferson Station, NY 11776-1210
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Vascular Surgery Physician Primary | 2086S0129X | 186340 (NY) |
| Vascular Surgery Physician | 2086S0129X | 193100 (NY) |
| Vascular Surgery Physician | 2086S0129X | 221708 (NY) |
| Vascular Surgery Physician | 2086S0129X | 099574 (NY) |
Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
About NPI 1144553025
Vascular Interventional Services, PLLC's National Provider Identifier is 1144553025, issued on Sep 10, 2009. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Port Jefferson Sta, NY. The record was last updated on May 25, 2016.