Provider Demographics
NPI: | 1548940273 |
---|---|
Name: | SOUTH WESTCHESTER VEIN & VASCULAR PLLC |
Entity type: | Organization |
Organization Name: | SOUTH WESTCHESTER VEIN & VASCULAR PLLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | PRADEEP |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GOYAL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 845-580-4222 |
Mailing Address - Street 1: | 441 CENTRAL PARK AVE STE 627 |
Mailing Address - Street 2: | |
Mailing Address - City: | SCARSDALE |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10583-1016 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1976 CROTONA PKWY |
Practice Address - Street 2: | 3RD FLOOR, STE 3C |
Practice Address - City: | BRONX |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10460-1526 |
Practice Address - Country: | US |
Practice Address - Phone: | 914-200-1586 |
Practice Address - Fax: | 914-200-1586 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-07-18 |
Last Update Date: | 2025-06-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 207RH0005X | Allopathic & Osteopathic Physicians | Internal Medicine | Hypertension Specialist | Group - Multi-Specialty |
No | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | Group - Multi-Specialty |
No | 246XC2903X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist Cardiovascular | Vascular Specialist | Group - Multi-Specialty |
No | 2471C1101X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Cardiovascular-Interventional Technology | Group - Multi-Specialty |
No | 2471N0900X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Nuclear Medicine Technology | Group - Multi-Specialty |
No | 2471V0106X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Vascular-Interventional Technology | Group - Multi-Specialty |