Provider Demographics
NPI:1386218006
Name:SAS PHYSICIAN SERVICES, PLLC
Entity Type:Organization
Organization Name:SAS PHYSICIAN SERVICES, PLLC
Other - Org Name:DOWNTOWN VEIN AND VASCULAR TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGEI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOBOLEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-267-3432
Mailing Address - Street 1:40 E OAKDENE AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1630
Mailing Address - Country:US
Mailing Address - Phone:646-267-3432
Mailing Address - Fax:718-603-9469
Practice Address - Street 1:480 COURT ST STE 101
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4091
Practice Address - Country:US
Practice Address - Phone:718-393-5559
Practice Address - Fax:718-603-9469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-17
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty