ATLANTA LASER VEIN INSTITUTE, LLC (NPI# 1245638998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245638998 |
| Entity Type | Organization |
| Organization Name | ATLANTA LASER VEIN INSTITUTE, LLC |
| Practice Address |
1050 E Piedmont Rd Suite 104 Marietta GA 30062-4758 |
| Mailing Address |
4141 Dundee Rd Northbrook IL 60062-2129 |
| Practice Telephone | 8473053346 |
| Practice Fax Number | 2242468042 |
| Mailing Telephone | 8473053346 |
| Mailing Fax Number | 2242468042 |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |
| Authorized Official Name | DR. YAN KATSNELSON (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 8473053346 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
1050 E PIEDMONT RD SUITE 104 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-4758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518906577 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 1050 E Piedmont Rd, Marietta, GA 30062-4758 | 2006-06-05 |
| 1598312472 | Lidia Girma | Pharmacist | 1050 E Piedmont Rd, Marietta, GA 30062-4758 | 2019-08-24 |
| 1417481599 | Sage Dental Group of Georgia LLC | Dentist | 1050 E Piedmont Rd, Suite 114-118, Marietta, GA 30062-4758 | 2017-04-17 |
| 1447627104 | Kingsley Onokalah | Pharmacist | 1050 E Piedmont Rd, Suite P, Marietta, GA 30062-4758 | 2015-08-28 |
| 1609283316 | Trent Leonard | Pharmacist | 1050 E Piedmont Rd, Suite #130 - Publix Pharmacy, Marietta, GA 30062-4758 | 2014-07-14 |
| 1295073260 | Kimberly Addy | Pharmacist | 1050 E Piedmont Rd, Marietta, GA 30062-4758 | 2013-01-24 |
| 1306183231 | Christine K Walker | Pharmacist | 1050 E Piedmont Rd, Marietta, GA 30062-4758 | 2013-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477594547 | Jeffrey Neil Winter | Surgery | 61 Whitcher St Ne Ste 2100, Marietta, GA 30060-1179 | 2006-06-09 |
| 1891788600 | Steven W. Oweida | Surgery | 61 Whitcher Street Ne, Suite 2100, Marietta, GA 30060 | 2005-08-26 |
| 1619355906 | Anand Parikh | Surgery | 61 Whitcher St Ne Ste 2100, Marietta, GA 30060-1179 | 2015-05-07 |
| 1750678637 | Emily Lagergren | Surgery | 61 Whitcher St Ne Ste 2100, Marietta, GA 30060 | 2011-06-29 |
| 1033382122 | Michael Richard Corey | Surgery | 61 Whitcher St Ne, Suite 2100, Marietta, GA 30060-1176 | 2008-04-09 |
| 1114083532 | Vascular Surgical Associates, PC | Surgery | 61 Whitcher St Ne Ste 2100, Marietta, GA 30060-1179 | 2006-12-29 |
| 1801979992 | Steven Paul Rivers | Surgery | 400 Matthew St, Suite 208, Marietta, OH 45750-1644 | 2006-10-23 |
| 1205875739 | John E Jones | Surgery | 61 Whitcher Street Ne, Suite 2100, Marietta, GA 30060-1179 | 2006-06-06 |
| 1932176377 | Charles W Wyble Jr. | Surgery | 61 Whitcher Street Ne, Suite 2100, Marietta, GA 30060-1179 | 2006-03-03 |
| 1144219239 | John Tucker | Surgery | 790 Church St Ne, Suite 570, Marietta, GA 30060-7282 | 2005-10-20 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.