Provider Demographics
NPI:1619492709
Name:VANISH, LLC
Entity Type:Organization
Organization Name:VANISH, LLC
Other - Org Name:VANISH - ADVANCED VEIN TREATMENTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABERNETHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-476-4900
Mailing Address - Street 1:7003 S HOWELL AVE STE 1600
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-1460
Mailing Address - Country:US
Mailing Address - Phone:262-439-9725
Mailing Address - Fax:414-395-8925
Practice Address - Street 1:7003 S HOWELL AVE STE 1600
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-1460
Practice Address - Country:US
Practice Address - Phone:262-476-4900
Practice Address - Fax:414-395-8925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-09
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty