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General NPI Number Information
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NPI Number | 1972901627
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Entity Type | Organization
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Legal Business Name | USA VEIN CLINICS OF ATLANTA
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 12/11/2014
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Provider Practice Location Address
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Address Line | 4141 DUNDEE RD
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City | NORTHBROOK
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State | IL
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Zip | 60062-2129
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Country | US
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Telephone | 847-305-3346
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Fax | 224-246-8042
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Provider Business Mailing Address
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Address Line | 1230 UPPER HEMBREE RD SUITE 202
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City | ROSWELL
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State | GA
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Zip | 30076-0911
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Country | US
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Telephone | 847-305-3346
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Fax | 224-246-8042
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. YAN KATSNELSON
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Credential | MD
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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 | 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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