Healthcare Provider Details

I. General information

NPI: 1023840121
Provider Name (Legal Business Name): UNIVERSAL ULTRASOUND DIAGNOSTIC & VEIN TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 E D ST
DEER PARK WA
99006-5167
US

IV. Provider business mailing address

111 HARRISON ST
FRENCHTOWN NJ
08825-1108
US

V. Phone/Fax

Practice location:
  • Phone: 800-571-0139
  • Fax:
Mailing address:
  • Phone: 908-493-2137
  • Fax: 908-382-1715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE CARDOSO
Title or Position: CEO
Credential:
Phone: 908-493-2137