PERIPHERAL VASCULAR INSTITUTE OF PHILADELPHIA LLC (NPI# 1396074480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396074480 |
| Entity Type | Organization |
| Organization Name | PERIPHERAL VASCULAR INSTITUTE OF PHILADELPHIA LLC |
| Practice Address |
4220 Market St 2nd Floor Philadelphia PA 19104-3007 |
| Mailing Address |
4220 Market St Fl 2 Philadelphia PA 19104-3007 |
| Practice Telephone | 2153823680 |
| Practice Fax Number | 2153823683 |
| Mailing Telephone | 2153823680 |
| Mailing Fax Number | 2153823683 |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2020-03-24 |
| Authorized Official Name | JAMES MCGUCKIN (CEO) |
| Authorized Official Telephone | 2153823680 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471V0106X |
Radiologic Technologist Specialization: Vascular-Interventional Technology |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
4220 MARKET ST 2ND FLOOR |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-3007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215132709 | Us Vascular Access Center of Philadelphia, LLC | Clinic/Center | 4220 Market St, Second Floor, Philadelphia, PA 19104-3007 | 2007-06-15 |
| 1326338310 | Mary Elizabeth Mccusker | Nurse Practitioner | 4220 Market St, 2nd Floor, Philadelphia, PA 19104-3007 | 2011-04-12 |
| 1225212137 | Us Vascular Access Center of Philadelphia, LLC | Clinical Medical Laboratory | 4220 Market St, Second Floor, Philadelphia, PA 19104-3007 | 2007-12-27 |
| 1255536496 | Us Vascular Access Center of Philadelphia, LLC | Clinic/Center | 4220 Market St, Second Floor, Philadelphia, PA 19104-3007 | 2007-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2471V0106X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Vascular-Interventional Technology |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134643802 | Roger Sze | Radiologic Technologist | 904 Phipps Way, Blue Bell, PA 19422 | 2017-08-03 |
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on PERIPHERAL VASCULAR INSTITUTE OF PHILADELPHIA LLC.
| 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.