Provider Demographics
NPI:1598048233
Name:CCC VEIN CARE LLC
Entity Type:Organization
Organization Name:CCC VEIN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ADMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-605-3035
Mailing Address - Street 1:103 RIVER RD
Mailing Address - Street 2:SUITE202
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1016
Mailing Address - Country:US
Mailing Address - Phone:201-605-3035
Mailing Address - Fax:201-941-1235
Practice Address - Street 1:103 RIVER RD
Practice Address - Street 2:SUITE202
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1016
Practice Address - Country:US
Practice Address - Phone:201-605-3035
Practice Address - Fax:201-941-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07010400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty