Provider Demographics
NPI:1235779877
Name:PREMIER VEIN CARE OF N.J., L.L.C.
Entity Type:Organization
Organization Name:PREMIER VEIN CARE OF N.J., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-718-7670
Mailing Address - Street 1:822 NORTH WOOD AVE
Mailing Address - Street 2:3RD FLOOR, SUITE 2
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036
Mailing Address - Country:US
Mailing Address - Phone:732-718-7670
Mailing Address - Fax:
Practice Address - Street 1:822 NORTH WOOD AVE
Practice Address - Street 2:3RD FLOOR, SUITE 2
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036
Practice Address - Country:US
Practice Address - Phone:732-718-7670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-12
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric