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General NPI Number Information
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NPI Number | 1700697810
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Entity Type | Organization
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Legal Business Name | DOWNTOWN VEIN AND VASCULAR LLC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 40 E OAKDENE AVE UNIT A
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City | PALISADES PARK
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State | NJ
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Zip | 07650-1630
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Country | US
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Telephone | 646-267-3432
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Fax |
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Provider Business Mailing Address
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Address Line | 117 W CENTRAL BLVD UNIT 16
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City | PALISADES PARK
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State | NJ
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Zip | 07650-5002
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Country | US
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Telephone | 646-267-3432
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SERGEI SOBOLEVSKY
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Credential | MD
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Telephone | 646-267-3432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound 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 | 2085N0904X
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Taxonomy Name | Nuclear Radiology 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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