Provider Demographics
NPI:1407823453
Name:VASCULAR SURGERY NON INVASIVE LAB INC
Entity Type:Organization
Organization Name:VASCULAR SURGERY NON INVASIVE LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-342-4030
Mailing Address - Street 1:1445 PORTLAND AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1445 PORTLAND AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3036
Practice Address - Country:US
Practice Address - Phone:585-342-4030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY16766BMedicare ID - Type Unspecified
NYMD405WMedicare UPIN