1932358322 NPI number — VASCULAR SURGERY PARTNERS PC

Table of content: (NPI 1932358322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932358322 NPI number — VASCULAR SURGERY PARTNERS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VASCULAR SURGERY PARTNERS PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932358322
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1445 PORTLAND AVE
Provider Second Line Business Mailing Address:
SUITE 109
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14621-3036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-342-4030
Provider Business Mailing Address Fax Number:
585-922-5430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 SUNSET DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14513-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-359-2661
Provider Business Practice Location Address Fax Number:
315-359-2128
Provider Enumeration Date:
09/10/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GEARY
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
585-342-4030

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)