# HERITAGE VASCULAR PC

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

## Provider details

- **NPI number:** 1568936326
- **Authorized official:** NIRMAN TULSYAN MD (CEO)
- **Authorized official phone:** (201) 283-4363

## Contact information

- **Practice address:** 663 E CRESCENT AVE STE 111, RAMSEY, NJ 07446-1220
- **Practice address phone:** (201) 283-4363
- **Mailing address:** 663 E CRESCENT AVE STE 111, RAMSEY, NJ 07446-1220
- **Mailing address phone:** (201) 283-4363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2019
- **Last updated:** 07/10/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 25MA08054200 | PROV LIC NUMBER | NJ |