Provider Demographics
NPI:1275277584
Name:HERITAGE VASCULAR ASSOCIATES LLC
Entity Type:Organization
Organization Name:HERITAGE VASCULAR ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TULSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-400-8405
Mailing Address - Street 1:7 SPIELMAN RD STE B
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-3403
Mailing Address - Country:US
Mailing Address - Phone:973-777-7361
Mailing Address - Fax:973-779-7385
Practice Address - Street 1:7 SPIELMAN RD STE B
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-3403
Practice Address - Country:US
Practice Address - Phone:973-777-7361
Practice Address - Fax:973-779-7385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty