Provider Demographics
NPI:1912231507
Name:DIAGNOSTIC VASCULAR TECHNOLOGIES LLC
Entity Type:Organization
Organization Name:DIAGNOSTIC VASCULAR TECHNOLOGIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SASEK
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:914-231-5154
Mailing Address - Street 1:6 HUDSON TER
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2104
Mailing Address - Country:US
Mailing Address - Phone:914-231-5154
Mailing Address - Fax:
Practice Address - Street 1:6 HUDSON TER
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2104
Practice Address - Country:US
Practice Address - Phone:914-231-5154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
112690261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile