Provider Demographics
NPI:1962704791
Name:COMPREHENSIVE VASCULAR CENTER, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE VASCULAR CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:SYREK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-307-2300
Mailing Address - Street 1:499 MARLBORO RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3746
Mailing Address - Country:US
Mailing Address - Phone:732-307-2300
Mailing Address - Fax:732-307-2303
Practice Address - Street 1:499 MARLBORO RD
Practice Address - Street 2:SUITE 1
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3746
Practice Address - Country:US
Practice Address - Phone:732-307-2300
Practice Address - Fax:732-307-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty