Provider Demographics
NPI:1609034396
Name:VASCULAR ACCESS CENTER OF NEW ORLEANS, LLC
Entity Type:Organization
Organization Name:VASCULAR ACCESS CENTER OF NEW ORLEANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-382-3680
Mailing Address - Street 1:2929 ARCH STREET
Mailing Address - Street 2:SUITE 1750
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2866
Mailing Address - Country:US
Mailing Address - Phone:215-382-3680
Mailing Address - Fax:215-240-1677
Practice Address - Street 1:1 GALLERIA BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2082
Practice Address - Country:US
Practice Address - Phone:504-708-4400
Practice Address - Fax:504-708-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DG27Medicare PIN