Provider Demographics
NPI:1851739601
Name:VASCULAR INTERVENTIONAL SERVICES
Entity Type:Organization
Organization Name:VASCULAR INTERVENTIONAL SERVICES
Other - Org Name:BUFFALO VASCULAR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AZHER
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-859-1062
Mailing Address - Street 1:9 ORCHARD HILL DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-3524
Mailing Address - Country:US
Mailing Address - Phone:716-859-1062
Mailing Address - Fax:
Practice Address - Street 1:6335 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1030
Practice Address - Country:US
Practice Address - Phone:716-859-1062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty