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General NPI Number Information
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NPI Number | 1699189191
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Entity Type | Organization
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Legal Business Name | HAMPTONS VEIN & VASCULAR PC
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 325 MEETING HOUSE LN BLDG 1, SUITE A
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-5087
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Country | US
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Telephone | 631-283-3583
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Fax | 631-283-0219
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Provider Business Mailing Address
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Address Line | 325 MEETING HOUSE LN BLDG 1, SUITE A
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-5087
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Country | US
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Telephone | 631-283-3583
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Fax | 631-283-0219
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Authorized Official
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Title or Position | OWNER
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Name | RASHMI SHARMA
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Credential | MD
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Telephone | 631-283-3583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 254930-1
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License Number State | NY
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