Provider Demographics
NPI:1063216711
Name:PINNACLE VASCULAR INSTITUTE LLC
Entity type:Organization
Organization Name:PINNACLE VASCULAR INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-379-1200
Mailing Address - Street 1:303 GEORGE ST STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2009
Mailing Address - Country:US
Mailing Address - Phone:732-993-5500
Mailing Address - Fax:732-993-7700
Practice Address - Street 1:303 GEORGE ST STE 105
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2009
Practice Address - Country:US
Practice Address - Phone:732-993-5500
Practice Address - Fax:732-993-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty