Provider Demographics
NPI:1497157630
Name:CENTER FOR ADVANCED VEIN THERAPY, P.C
Entity Type:Organization
Organization Name:CENTER FOR ADVANCED VEIN THERAPY, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:267-728-7440
Mailing Address - Street 1:2600 PHILMONT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5306
Mailing Address - Country:US
Mailing Address - Phone:267-728-7440
Mailing Address - Fax:844-684-8346
Practice Address - Street 1:2600 PHILMONT AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5306
Practice Address - Country:US
Practice Address - Phone:267-728-7440
Practice Address - Fax:844-684-8346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004114L2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty