Healthcare Provider Details

I. General information

NPI: 1245663236
Provider Name (Legal Business Name): USA VEIN CLINICS OF NEW JERSEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 SHREWSBURY AVE STE 300
TINTON FALLS NJ
07724-3001
US

IV. Provider business mailing address

304 WAINWRIGHT DR STE 120
NORTHBROOK IL
60062-1919
US

V. Phone/Fax

Practice location:
  • Phone: 847-593-8460
  • Fax: 224-246-8042
Mailing address:
  • Phone: 847-257-1244
  • Fax: 224-246-8042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER MORRISON
Title or Position: OWNER
Credential: MD
Phone: 727-644-3038