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Organization

ASSOCIATES IN VASCULAR CARE LLC LIMB SALVAGE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. OWANO PENNYCOOKE MD (PRESIDENT)
(732) 784-6550
Entity
Organization

Contact information

Practice address
1000 ROUTE 35 SOUTH, SUITE 300, MIDDLETOWN, NJ 07748-2606
(732) 784-6550
(732) 737-9836
Mailing address
3587 HIGHWAY 9 NORTH, SUITE 224, FREEHOLD, NJ 07728
(732) 784-6550

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
25MA08547000
NJ

Other

Enumeration date
09/09/2015
Last updated
09/09/2015
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