# WATERFORD VASCULAR ASSOCIATES, P.C.

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

## Provider details

- **NPI number:** 1336781236
- **Authorized official:** LORENA ESPARZA (REVENUE CYCLE MANAGER)
- **Authorized official phone:** (630) 725-2764

## Contact information

- **Practice address:** 903 HARTFORD TPKE UNIT 30, WATERFORD, CT 06385-4264
- **Practice address phone:** (860) 772-1998
- **Practice address fax:** (860) 772-1999
- **Mailing address:** 2001 BUTTERFIELD RD STE 300, DOWNERS GROVE, IL 60515-1069
- **Mailing address phone:** (630) 725-2700
- **Mailing address fax:** (833) 842-5469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/11/2019
- **Last updated:** 10/11/2019