Provider Demographics
NPI:1376719021
Name:VASCULORENAL IMAGING LLC
Entity Type:Organization
Organization Name:VASCULORENAL IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:COVIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-390-4888
Mailing Address - Street 1:465 CRANBURY RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-7600
Mailing Address - Country:US
Mailing Address - Phone:732-390-4888
Mailing Address - Fax:732-390-0255
Practice Address - Street 1:465 CRANBURY RD
Practice Address - Street 2:SUITE 204
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-7600
Practice Address - Country:US
Practice Address - Phone:732-390-4888
Practice Address - Fax:732-390-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ084376Medicare PIN