Healthcare Provider Details

I. General information

NPI: 1376958686
Provider Name (Legal Business Name): VASCULAR CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 05/18/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 STANTON CHRISTIANA RD SUITE 201
NEWARK DE
19713-2133
US

IV. Provider business mailing address

620 STANTON CHRISTIANA RD SUITE 201
NEWARK DE
19713-2133
US

V. Phone/Fax

Practice location:
  • Phone: 302-338-9444
  • Fax: 302-994-9449
Mailing address:
  • Phone: 302-338-9444
  • Fax: 302-994-9449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC10005636
License Number StateDE

VIII. Authorized Official

Name: ASHISH B PARIKH
Title or Position: CEO
Credential: MD
Phone: 302-338-9444