MEDICARE: VASCULAR SURGICAL SPECIALISTS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician		PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932610755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VASCULAR SURGICAL SPECIALISTS PLLC

Provider Business Mailing Address
First Line	:	1450 E BOOT RD STE 600B
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-5968
Country	:	US
Telephone Number	:	610-430-8272
Fax Number	:	888-871-0040

Provider Business Practice Location Address
First Line	:	1450 E BOOT RD STE 700A
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-5962
Country	:	US
Telephone Number	:	610-430-8272
Fax Number	:	888-871-0040

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	SEAN V. RYAN
Credential	:	MD
Telephone Number	:	610-430-8272

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	04/11/2024

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