Healthcare Provider Details

I. General information

NPI: 1407823453
Provider Name (Legal Business Name): VASCULAR SURGERY NON INVASIVE LAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 PORTLAND AVE SUITE 109
ROCHESTER NY
14621-3036
US

IV. Provider business mailing address

1445 PORTLAND AVE SUITE 109
ROCHESTER NY
14621-3036
US

V. Phone/Fax

Practice location:
  • Phone: 585-342-4030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN J. GEARY
Title or Position: PRESIDENT
Credential:
Phone: 585-342-4030