MEDICARE: VASCULAR CARE 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	2086S0129X	Vascular Surgery Physician	172943	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508973298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VASCULAR CARE PC

Provider Business Mailing Address
First Line	:	4221 MEDICAL CENTER DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NY
Zip	:	13066-6637
Country	:	US
Telephone Number	:	315-329-7711
Fax Number	:	315-329-7755

Provider Business Practice Location Address
First Line	:	6221 STATE ROUTE 31
Second Line	:	SUITE 104
City	:	CICERO
State	:	NY
Zip	:	13039-8715
Country	:	US
Telephone Number	:	315-752-0141
Fax Number	:	315-752-0142

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT A SCHWARTZ
Credential	:	MD
Telephone Number	:	315-329-7711

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	05/05/2008

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