Provider Demographics
NPI:1700012242
Name:VSH MEDICAL & DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:VSH MEDICAL & DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:I
Authorized Official - Last Name:RAMGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-223-0202
Mailing Address - Street 1:7912 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-6271
Mailing Address - Country:US
Mailing Address - Phone:201-223-0202
Mailing Address - Fax:201-223-0233
Practice Address - Street 1:435 57TH ST
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-2119
Practice Address - Country:US
Practice Address - Phone:201-223-0202
Practice Address - Fax:201-223-0233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA66179207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG44038Medicare UPIN