Provider Demographics
NPI:1093941718
Name:NORTH COUNTRY VASCULAR DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:NORTH COUNTRY VASCULAR DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RVT, RDMS
Authorized Official - Phone:518-793-9820
Mailing Address - Street 1:84 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4381
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:46 ELM ST
Practice Address - Street 2:BILLING OFFICE
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3524
Practice Address - Country:US
Practice Address - Phone:518-793-9820
Practice Address - Fax:518-793-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Single Specialty