Provider Demographics
NPI:1326008061
Name:VASCULAR CONSULTANTS INC
Entity Type:Organization
Organization Name:VASCULAR CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZISKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-816-5488
Mailing Address - Street 1:7225 OLD OAK BLVD
Mailing Address - Street 2:STE B306
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3339
Mailing Address - Country:US
Mailing Address - Phone:440-816-5783
Mailing Address - Fax:440-816-4069
Practice Address - Street 1:7225 OLD OAK BLVD
Practice Address - Street 2:STE B306
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3339
Practice Address - Country:US
Practice Address - Phone:440-816-5783
Practice Address - Fax:440-816-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-25
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0550103Medicaid
OHCB5271OtherRAILROAD MEDICARE
OHID01122Medicare PIN
OHID01121Medicare PIN