Healthcare Provider Details

I. General information

NPI: 1023369485
Provider Name (Legal Business Name): OCEAN STATE CARDIOVASCULAR AND VEIN CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 SOCIAL ST
WOONSOCKET RI
02895-3240
US

IV. Provider business mailing address

PO BOX 68
OSCEOLA MILLS PA
16666-0068
US

V. Phone/Fax

Practice location:
  • Phone: 802-233-8759
  • Fax:
Mailing address:
  • Phone: 814-339-7101
  • Fax: 814-339-6165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. WALID S SABER
Title or Position: OWNER
Credential: M.D.
Phone: 802-233-8759