Provider Demographics
NPI:1437525490
Name:ADVANCED VEIN AND LASER CENTER LANCASTER, LLC
Entity Type:Organization
Organization Name:ADVANCED VEIN AND LASER CENTER LANCASTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WINAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-682-0705
Mailing Address - Street 1:116 ROUNDTOP DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2441
Mailing Address - Country:US
Mailing Address - Phone:717-682-0705
Mailing Address - Fax:
Practice Address - Street 1:896A PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2745
Practice Address - Country:US
Practice Address - Phone:717-682-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 066588L2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH36683Medicare UPIN