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General NPI Number Information
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NPI Number | 1912301003
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Entity Type | Organization
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Legal Business Name | USA VEIN CLINICS OF DECATUR LLC
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 495 WINN WAY SUITE 220
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City | DECATUR
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State | GA
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Zip | 30030-1736
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Country | US
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Telephone | 847-305-3346
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Fax |
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Provider Business Mailing Address
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Address Line | 495 WINN WAY SUITE 220
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City | DECATUR
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State | GA
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Zip | 30030-1736
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Country | US
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Telephone | 847-305-3346
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YAN KATSNELSON
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Credential | M.D.
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Telephone | 847-305-3346
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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 | 207Q00000X
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Taxonomy Name | Family Medicine 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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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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 #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #10
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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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