Organization
GLASTONBURY VASCULAR ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA ESPARZA (REVENUE CYCLE MANAGER)
(630) 725-2764
Entity
Organization
Contact information
Practice address
95 GLASTONBURY BLVD STE 202, GLASTONBURY, CT 06033-4456
(860) 652-8400
(860) 652-8401
Mailing address
2001 BUTTERFIELD RD STE 300, DOWNERS GROVE, IL 60515-1069
(630) 725-2700
(833) 842-5469
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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