Provider Demographics
NPI:1154622801
Name:VEIN TREATMENT CENTER
Entity type:Organization
Organization Name:VEIN TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-612-1750
Mailing Address - Street 1:1 W RIDGEWOOD AVE
Mailing Address - Street 2:#306
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2361
Mailing Address - Country:US
Mailing Address - Phone:201-612-1750
Mailing Address - Fax:201-612-1760
Practice Address - Street 1:1 W RIDGEWOOD AVE
Practice Address - Street 2:#306
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2361
Practice Address - Country:US
Practice Address - Phone:201-612-1750
Practice Address - Fax:201-612-1760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA039891002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty