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General NPI Number Information
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NPI Number | 1053729988
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Entity Type | Individual
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Provider Name | KUNAL VANI
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Gender | Male
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 333 MOUNT HOPE AVE STE 260
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City | ROCKAWAY
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State | NJ
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Zip | 07866-1657
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Country | US
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Telephone | 973-895-6605
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Fax | 973-895-5338
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Provider Business Mailing Address
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Address Line | PO BOX 416457
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City | BOSTON
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State | MA
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Zip | 02241-6457
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Country | US
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Telephone | 844-362-1735
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Fax | 973-290-7495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 25MB11094600
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License Number State | NJ
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