Provider Demographics
NPI:1245415322
Name:VASCULAR ASSOCIATES OF LONG ISLAND, PC
Entity Type:Organization
Organization Name:VASCULAR ASSOCIATES OF LONG ISLAND, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LASNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-331-4540
Mailing Address - Street 1:4 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-4068
Mailing Address - Country:US
Mailing Address - Phone:631-246-8289
Mailing Address - Fax:
Practice Address - Street 1:4 TECHNOLOGY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-4068
Practice Address - Country:US
Practice Address - Phone:631-246-8289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty