Provider Demographics
NPI:1699189191
Name:HAMPTONS VEIN & VASCULAR PC
Entity Type:Organization
Organization Name:HAMPTONS VEIN & VASCULAR PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RASHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-283-3583
Mailing Address - Street 1:325 MEETING HOUSE LN
Mailing Address - Street 2:BLDG 1, SUITE A
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-5087
Mailing Address - Country:US
Mailing Address - Phone:631-283-3583
Mailing Address - Fax:631-283-0219
Practice Address - Street 1:325 MEETING HOUSE LN
Practice Address - Street 2:BLDG 1, SUITE A
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5087
Practice Address - Country:US
Practice Address - Phone:631-283-3583
Practice Address - Fax:631-283-0219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254930-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty