Provider Demographics
NPI:1174802516
Name:VASCULAR IMAGING, PC
Entity type:Organization
Organization Name:VASCULAR IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:SRIVASTAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-297-8398
Mailing Address - Street 1:1600 DEER PARK AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-5208
Mailing Address - Country:US
Mailing Address - Phone:888-848-2060
Mailing Address - Fax:888-848-6614
Practice Address - Street 1:162-15 HIGHLAND AVE
Practice Address - Street 2:APT 1A
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-297-8398
Practice Address - Fax:718-297-0063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty