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General NPI Number Information
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NPI Number | 1063216711
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Entity Type | Organization
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Legal Business Name | PINNACLE VASCULAR INSTITUTE LLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 303 GEORGE ST STE 105
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2009
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Country | US
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Telephone | 732-735-0987
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Fax | 732-605-5850
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Provider Business Mailing Address
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Address Line | 303 GEORGE ST STE 105
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2009
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Country | US
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Telephone | 732-735-0987
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Fax | 732-605-5850
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Authorized Official
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Title or Position | OWNER
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Name | DAVID O'CONNOR
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Credential | MD
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Telephone | 646-379-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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