Provider Demographics
NPI:1629217393
Name:COMPREHENSIVE VASCULAR CARE, PA
Entity Type:Organization
Organization Name:COMPREHENSIVE VASCULAR CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TUSHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPATHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-305-6444
Mailing Address - Street 1:312 APPLEGARTH ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5347
Mailing Address - Country:US
Mailing Address - Phone:732-305-6444
Mailing Address - Fax:732-305-6445
Practice Address - Street 1:312 APPLEGARTH ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-5347
Practice Address - Country:US
Practice Address - Phone:201-220-7931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA075011002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA07501100OtherNEW JERSEY LICENSE