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General NPI Number Information
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NPI Number | 1174802516
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Entity Type | Organization
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Legal Business Name | VASCULAR IMAGING, PC
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 162-15 HIGHLAND AVE APT 1A
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone | 718-297-8398
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Fax | 718-297-0063
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Provider Business Mailing Address
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Address Line | 1600 DEER PARK AVE SUITE A
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City | DEER PARK
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State | NY
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Zip | 11729-5208
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Country | US
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Telephone | 888-848-2060
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Fax | 888-848-6614
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAJEEV SRIVASTAVA
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Credential | MD
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Telephone | 718-297-8398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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