Provider Demographics
NPI:1972901627
Name:USA VEIN CLINICS OF ATLANTA
Entity Type:Organization
Organization Name:USA VEIN CLINICS OF ATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KATSNELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-305-3346
Mailing Address - Street 1:1230 UPPER HEMBREE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0911
Mailing Address - Country:US
Mailing Address - Phone:847-305-3346
Mailing Address - Fax:224-246-8042
Practice Address - Street 1:4141 DUNDEE RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2129
Practice Address - Country:US
Practice Address - Phone:847-305-3346
Practice Address - Fax:224-246-8042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty