MEDICARE: VASCULAR SPECIALISTS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1154057867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VASCULAR SPECIALISTS PC

Provider Business Mailing Address
First Line	:	86 ASHLEY AVE
Second Line	:
City	:	W SPRINGFIELD
State	:	MA
Zip	:	01089-1302
Country	:	US
Telephone Number	:	413-693-2852
Fax Number	:	413-469-2854

Provider Business Practice Location Address
First Line	:	86 ASHLEY AVE
Second Line	:
City	:	W SPRINGFIELD
State	:	MA
Zip	:	01089-1302
Country	:	US
Telephone Number	:	413-693-2852
Fax Number	:	413-469-2854

Authorized Official
Title or Position	:	OWNER
Name	:	SIDNEY LOWELL KAHN
Credential	:	MD
Telephone Number	:	413-693-2852

Provider Enumeration Date	:	07/26/2022
Last Update Date	:	09/30/2022

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