Healthcare Provider Details

I. General information

NPI: 1427018167
Provider Name (Legal Business Name): VASCULAR SURGICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7255 OLD OAK BLVD STE 108
CLEVELAND OH
44130-3329
US

IV. Provider business mailing address

7255 OLD OAK BLVD STE 108
CLEVELAND OH
44130-3329
US

V. Phone/Fax

Practice location:
  • Phone: 440-816-5488
  • Fax: 440-816-4069
Mailing address:
  • Phone: 440-816-5488
  • Fax: 440-816-4069

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: MARTHA ZISKA
Title or Position: BUSINESS MANAGER
Credential:
Phone: 440-816-5488