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General NPI Number Information
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NPI Number | 1740956754
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Entity Type | Organization
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Legal Business Name | CINCINNATI ENDOVASCULAR CENTER LLC
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 2950 GLENDALE MILFORD RD STE 520
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City | CINCINNATI
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State | OH
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Zip | 45241-3131
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Country | US
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Telephone | 513-773-3440
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Fax | 513-773-3439
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Provider Business Mailing Address
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Address Line | 182 INDUSTRIAL RD
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City | GLEN ROCK
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State | PA
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Zip | 17327-8626
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Country | US
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Telephone | 717-759-5148
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Fax | 717-759-5435
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Authorized Official
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Title or Position | OWNER
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Name | MR. RAYMOND FIGUEROA
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Credential |
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Telephone | 717-759-5148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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