Provider Demographics
NPI:1427018167
Name:VASCULAR SURGICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:VASCULAR SURGICAL ASSOCIATES 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 1:7255 OLD OAK BLVD
Mailing Address - Street 2:STE 108
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3329
Mailing Address - Country:US
Mailing Address - Phone:440-816-5488
Mailing Address - Fax:440-816-4069
Practice Address - Street 1:7255 OLD OAK BLVD
Practice Address - Street 2:STE 108
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3329
Practice Address - Country:US
Practice Address - Phone:440-816-5488
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:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0453281Medicaid
OHCJ0835OtherRAILROAD MEDICARE
OH9914043Medicare PIN