Healthcare Provider Details

I. General information

NPI: 1174168926
Provider Name (Legal Business Name): CENTER FOR VARICOSE VEINS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 DANBURY RD
WILTON CT
06897-4428
US

IV. Provider business mailing address

35 DANBURY RD STE 9
WILTON CT
06897-4444
US

V. Phone/Fax

Practice location:
  • Phone: 203-529-5521
  • Fax:
Mailing address:
  • Phone: 203-762-6365
  • Fax: 203-762-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VINAY MADAN
Title or Position: MEDICAL DIRECTOR
Credential: MD, DABVLM
Phone: 860-997-7498