Provider Demographics
NPI:1831294198
Name:ASSOCIATED VEIN SOLUTIONS, PC
Entity Type:Organization
Organization Name:ASSOCIATED VEIN SOLUTIONS, PC
Other - Org Name:DELAWARE VALLEY VEIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-933-2444
Mailing Address - Street 1:1260 VALLEY FORGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2691
Mailing Address - Country:US
Mailing Address - Phone:610-933-2444
Mailing Address - Fax:610-933-8520
Practice Address - Street 1:1260 VALLEY FORGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2691
Practice Address - Country:US
Practice Address - Phone:610-933-2444
Practice Address - Fax:610-933-8520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043999L2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2151793000OtherINDEPENDENCE BLUE CROSS
PA071435Medicare PIN