Provider Demographics
NPI:1508973298
Name:VASCULAR CARE PC
Entity Type:Organization
Organization Name:VASCULAR CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-329-7711
Mailing Address - Street 1:4221 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13066-6637
Mailing Address - Country:US
Mailing Address - Phone:315-329-7711
Mailing Address - Fax:315-329-7755
Practice Address - Street 1:6221 STATE ROUTE 31
Practice Address - Street 2:SUITE 104
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-8715
Practice Address - Country:US
Practice Address - Phone:315-752-0141
Practice Address - Fax:315-752-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1729432086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01051885Medicaid
NY01051885Medicaid
NY53787BMedicare ID - Type Unspecified