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General NPI Number Information
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NPI Number | 1659268050
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Entity Type | Organization
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Legal Business Name | METROVASCULAR LLC
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 111 WADSWORTH AVE
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City | NEW YORK
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State | NY
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Zip | 10033-6102
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Country | US
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Telephone | 973-795-4309
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Fax | 646-530-6930
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Provider Business Mailing Address
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Address Line | 111 WADSWORTH AVE
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City | NEW YORK
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State | NY
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Zip | 10033-6102
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Country | US
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Telephone | 973-795-4309
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Fax | 646-530-6930
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Authorized Official
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Title or Position | COO
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Name | DEANNE VANJONACK
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Credential | MSS,RDCS,RVS
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Telephone | 215-939-0668
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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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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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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 | 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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