Organization
MONMOUTH VASCULAR IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEV PUKIN MD (AUTHORIZED OFFICIAL)
(732) 201-2225
Entity
Organization
Contact information
Practice address
1198 LAKEWOOD RD, TOMS RIVER, NJ 08753-2237
(732) 201-2225
(888) 960-2493
Mailing address
4 MOUNTAIN LN, HOLMDEL, NJ 07733-1107
(732) 201-2225
(888) 960-2493
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
01/31/2020
Last updated
10/31/2020
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