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General NPI Number Information
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NPI Number | 1326095811
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Entity Type | Organization
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Legal Business Name | VASCTECH, INC.
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 175 JERICHO TPKE SUITE 217
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City | SYOSSET
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State | NY
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Zip | 11791-4532
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Country | US
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Telephone | 516-433-9141
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Fax | 516-433-1181
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Provider Business Mailing Address
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Address Line | 10 MONTGOMERY PL
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City | JERICHO
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State | NY
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Zip | 11753-1404
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Country | US
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Telephone | 516-433-9141
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Fax | 516-433-1181
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDREW JOSEPH BEBRY
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Credential | RVT, RCT
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Telephone | 516-433-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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