Provider Demographics
NPI:1922752450
Name:PISCATAWAY ENDOVASCULAR CENTER LLC
Entity type:Organization
Organization Name:PISCATAWAY ENDOVASCULAR CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-426-3636
Mailing Address - Street 1:182 INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:17327-8626
Mailing Address - Country:US
Mailing Address - Phone:833-426-3636
Mailing Address - Fax:717-759-5435
Practice Address - Street 1:1 WILLS WAY
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3770
Practice Address - Country:US
Practice Address - Phone:732-564-6351
Practice Address - Fax:732-564-6352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical