Provider Demographics
NPI:1144761685
Name:CENTER FOR VASCULAR MEDICINE NJ, LLC
Entity Type:Organization
Organization Name:CENTER FOR VASCULAR MEDICINE NJ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKHANPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-982-2000
Mailing Address - Street 1:7474 GREENWAY CENTER DR STE 650
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3560
Mailing Address - Country:US
Mailing Address - Phone:301-982-2000
Mailing Address - Fax:
Practice Address - Street 1:415 ROUTE 24 STE 6/7
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2920
Practice Address - Country:US
Practice Address - Phone:301-486-4690
Practice Address - Fax:301-982-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty