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General NPI Number Information
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NPI Number | 1558600635
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Entity Type | Organization
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Legal Business Name | VERACON INC
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 02/17/2013
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Provider Practice Location Address
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Address Line | 2511 S BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19148-4309
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Country | US
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Telephone | 856-873-7273
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Fax |
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Provider Business Mailing Address
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Address Line | 71 GREENS WAY
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City | BLACKWOOD
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State | NJ
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Zip | 08012-5574
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Country | US
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Telephone | 856-873-7273
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Fax |
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Authorized Official
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Title or Position | ECHOCARDIOGRAPHER/VASCULAR TECH
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Name | JAMES N BRYANT
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Credential | RDCS, RVT
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Telephone | 856-873-7273
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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 | NJ
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