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General NPI Number Information
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NPI Number | 1699155655
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Entity Type | Organization
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Legal Business Name | LONG ISLAND VEIN CARE & SURGERY PLLC
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 1325 FRANKLIN AVE SUITE 103B
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City | GARDEN CITY
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State | NY
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Zip | 11530-1666
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Country | US
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Telephone | 516-536-1818
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 FRANKLIN AVE SUITE 103B
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City | GARDEN CITY
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State | NY
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Zip | 11530-1666
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Country | US
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Telephone | 516-536-1818
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWIN ROSENWASSER
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Credential | M.D.
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Telephone | 516-536-1818
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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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