Provider Demographics
NPI:1962633370
Name:VASCULAR IMAGING PROFESSIONALS
Entity Type:Organization
Organization Name:VASCULAR IMAGING PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:N
Authorized Official - Last Name:SIVA-SUBRAMANIAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, RVT
Authorized Official - Phone:804-747-0030
Mailing Address - Street 1:7811 BISCAYNE RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-3403
Mailing Address - Country:US
Mailing Address - Phone:804-747-0300
Mailing Address - Fax:
Practice Address - Street 1:7811 BISCAYNE RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-3403
Practice Address - Country:US
Practice Address - Phone:804-747-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAV092090002471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty