Provider Demographics
NPI:1366237604
Name:VEIN LAB
Entity type:Organization
Organization Name:VEIN LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:OPHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDGISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-698-1995
Mailing Address - Street 1:2020 ALBEMARLE RD APT 6C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-8083
Mailing Address - Country:US
Mailing Address - Phone:929-698-1995
Mailing Address - Fax:
Practice Address - Street 1:2020 ALBEMARLE RD APT 6C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-8083
Practice Address - Country:US
Practice Address - Phone:929-698-1995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty