Healthcare Provider Details

I. General information

NPI: 1700012242
Provider Name (Legal Business Name): VSH MEDICAL & DIAGNOSTIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 06/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 57TH ST
WEST NEW YORK NJ
07093-2119
US

IV. Provider business mailing address

7912 RIVER RD
NORTH BERGEN NJ
07047-6271
US

V. Phone/Fax

Practice location:
  • Phone: 201-223-0202
  • Fax: 201-223-0233
Mailing address:
  • Phone: 201-223-0202
  • Fax: 201-223-0233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA66179
License Number StateNJ

VIII. Authorized Official

Name: DR. EMIL I RAMGEL
Title or Position: PRESIDENT
Credential: M.D
Phone: 201-223-0202