# CENTER OF INTERVENTIONAL MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** VidaVascular
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043171747
- **Authorized official:** MR. MEGHAL RAMESH ANTANI M.D. (CEO/OWNER)
- **Authorized official phone:** (866) 800-2346

## Contact information

- **Practice address:** 4255 ALTAMONT PLACE, SUITE 101, WHITE PLAINS, MD 20695-3066
- **Practice address phone:** (866) 800-2346
- **Practice address fax:** (301) 652-6332
- **Mailing address:** 4255 ALTAMONT PLACE, SUITE 101, WHITE PLAINS, MD 20695-3066
- **Mailing address phone:** (866) 800-2346
- **Mailing address fax:** (301) 652-6332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2025
- **Last updated:** 11/21/2025