Healthcare Provider Details

I. General information

NPI: 1386322345
Provider Name (Legal Business Name): ELITE VASCULAR SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 CLIFTON AVE
CLIFTON NJ
07013-2711
US

IV. Provider business mailing address

999 CLIFTON AVE
CLIFTON NJ
07013-2711
US

V. Phone/Fax

Practice location:
  • Phone: 908-400-8405
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NIRMAN TULSYAN
Title or Position: PRESIDENT
Credential: MD
Phone: 908-400-8405