Provider Demographics
NPI:1366716060
Name:VASCULAR SPECIALISTS, P.A.
Entity type:Organization
Organization Name:VASCULAR SPECIALISTS, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DISABATINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-543-8100
Mailing Address - Street 1:1 CENTURIAN DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2137
Mailing Address - Country:US
Mailing Address - Phone:302-543-8100
Mailing Address - Fax:302-543-8905
Practice Address - Street 1:1 CENTURIAN DR
Practice Address - Street 2:SUITE 307
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2137
Practice Address - Country:US
Practice Address - Phone:302-543-8100
Practice Address - Fax:302-543-8905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty