Provider Demographics
NPI:1285752246
Name:VASCULAR DIAGNOSTIC LAB OF NY,LLC
Entity type:Organization
Organization Name:VASCULAR DIAGNOSTIC LAB OF NY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PINKUS
Authorized Official - Middle Name:H
Authorized Official - Last Name:SZUCHMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-261-4411
Mailing Address - Street 1:10914 ASCAN AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5370
Mailing Address - Country:US
Mailing Address - Phone:718-261-4411
Mailing Address - Fax:718-793-6064
Practice Address - Street 1:10914 ASCAN AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5370
Practice Address - Country:US
Practice Address - Phone:718-261-4411
Practice Address - Fax:718-793-6064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory