Healthcare Provider Details

I. General information

NPI: 1710191424
Provider Name (Legal Business Name): VASCULAR DIAGNOSTIC ASSOC., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4161 KISSENA BLVD SUITE 4
FLUSHING NY
11355-3105
US

IV. Provider business mailing address

4161 KISSENA BLVD SUITE 4
FLUSHING NY
11355-3105
US

V. Phone/Fax

Practice location:
  • Phone: 718-886-0600
  • Fax: 718-886-5553
Mailing address:
  • Phone: 718-886-0600
  • Fax: 718-886-5553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTIN J. KAPLITT
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 718-886-0600