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General NPI Number Information
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NPI Number | 1235779877
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Entity Type | Organization
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Legal Business Name | PREMIER VEIN CARE OF N.J., L.L.C.
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Dates
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Enumeration Date | 01/12/2020
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Last Update Date | 01/12/2020
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Provider Practice Location Address
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Address Line | 822 NORTH WOOD AVE 3RD FLOOR, SUITE 2
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City | LINDEN
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State | NJ
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Zip | 07036
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Country | US
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Telephone | 732-718-7670
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Fax |
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Provider Business Mailing Address
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Address Line | 822 NORTH WOOD AVE 3RD FLOOR, SUITE 2
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City | LINDEN
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State | NJ
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Zip | 07036
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Country | US
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Telephone | 732-718-7670
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RANY SALEH
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Credential | D.O.
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Telephone | 732-718-7670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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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 | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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