# LASER AND VARICOSE VEIN TREATMENT CENTER OF STATEN ISLAND LLP

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

## Provider details

- **NPI number:** 1558450312
- **Authorized official:** KIMBERLY CHEMO (CREDENTIALING ADMINISTRATOR)
- **Authorized official phone:** (732) 387-2747

## Contact information

- **Practice address:** 500 SEAVIEW AVE, STE 240, STATEN ISLAND, NY 10305-3403
- **Practice address phone:** (718) 667-1777
- **Practice address fax:** (718) 667-4380
- **Mailing address:** 500 SEAVIEW AVE, STE 240, STATEN ISLAND, NY 10305-3403
- **Mailing address phone:** (718) 667-1777
- **Mailing address fax:** (718) 667-4380

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 119772 | NY | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 10/03/2023