Provider Demographics
NPI:1932358322
Name:VASCULAR SURGERY PARTNERS PC
Entity Type:Organization
Organization Name:VASCULAR SURGERY PARTNERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GEARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-342-4030
Mailing Address - Street 1:1445 PORTLAND AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3036
Mailing Address - Country:US
Mailing Address - Phone:585-342-4030
Mailing Address - Fax:585-922-5430
Practice Address - Street 1:75 SUNSET DR
Practice Address - Street 2:SUITE B
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1000
Practice Address - Country:US
Practice Address - Phone:315-359-2661
Practice Address - Fax:315-359-2128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100000012Medicare PIN