# MID-ATLANTIC VEIN AND VASCULAR INSTITUTE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134779093
- **Authorized official:** DR. HAYTHAM ALBIZEM MD (PRESIDENT)
- **Authorized official phone:** (267) 252-6408

## Contact information

- **Practice address:** 5600 CHESTNUT ST, PHILADELPHIA, PA 19139-3232
- **Practice address phone:** (267) 252-6408
- **Mailing address:** 5600 CHESTNUT ST, PHILADELPHIA, PA 19139-3232
- **Mailing address phone:** (267) 252-6408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/12/2019
- **Last updated:** 11/07/2019