Provider Demographics
NPI:1558600635
Name:VERACON INC
Entity Type:Organization
Organization Name:VERACON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ECHOCARDIOGRAPHER/VASCULAR TECH
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS, RVT
Authorized Official - Phone:856-873-7273
Mailing Address - Street 1:71 GREENS WAY
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-5574
Mailing Address - Country:US
Mailing Address - Phone:856-873-7273
Mailing Address - Fax:
Practice Address - Street 1:2511 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-4309
Practice Address - Country:US
Practice Address - Phone:856-873-7273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty