Provider Demographics
NPI:1043328248
Name:HACKENSACK NON INVASIVE VASCULAR LABORATORY ASSOCIATES
Entity Type:Organization
Organization Name:HACKENSACK NON INVASIVE VASCULAR LABORATORY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MASSIMO
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPOLITANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-343-0040
Mailing Address - Street 1:30 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1914
Mailing Address - Country:US
Mailing Address - Phone:201-996-2317
Mailing Address - Fax:201-996-2137
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:ROOM G231
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-2317
Practice Address - Fax:551-996-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3126609Medicare ID - Type UnspecifiedGROUP MEDICARE #