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General NPI Number Information
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NPI Number | 1992882211
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Entity Type | Organization
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Legal Business Name | VASCULAR SURGICAL ASSOC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1225 PARK AVE SUITE 1D
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-876-7400
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Fax | 212-831-8090
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Provider Business Mailing Address
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Address Line | 1225 PARK AVE SUITE 1D
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-876-7400
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Fax | 212-831-8090
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Authorized Official
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Title or Position | MD
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Name | DANIELLE BAJAKIAN
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Credential |
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Telephone | 212-876-7400
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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 | 709998
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License Number State | NY
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