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General NPI Number Information
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NPI Number | 1568936326
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Entity Type | Organization
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Legal Business Name | HERITAGE VASCULAR PC
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Dates
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Enumeration Date | 01/15/2019
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 663 E CRESCENT AVE STE 111
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City | RAMSEY
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State | NJ
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Zip | 07446-1220
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Country | US
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Telephone | 201-283-4363
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Fax |
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Provider Business Mailing Address
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Address Line | 663 E CRESCENT AVE STE 111
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City | RAMSEY
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State | NJ
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Zip | 07446-1220
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Country | US
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Telephone | 201-283-4363
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NIRMAN TULSYAN
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Credential | MD
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Telephone | 201-283-4363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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