Provider Demographics
NPI:1699155655
Name:LONG ISLAND VEIN CARE & SURGERY PLLC
Entity type:Organization
Organization Name:LONG ISLAND VEIN CARE & SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENWASSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-536-1818
Mailing Address - Street 1:1325 FRANKLIN AVE
Mailing Address - Street 2:SUITE 103B
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1666
Mailing Address - Country:US
Mailing Address - Phone:516-536-1818
Mailing Address - Fax:
Practice Address - Street 1:1325 FRANKLIN AVE
Practice Address - Street 2:SUITE 103B
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1666
Practice Address - Country:US
Practice Address - Phone:516-536-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty