Organization
WATERFORD VASCULAR ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA ESPARZA (REVENUE CYCLE MANAGER)
(630) 725-2764
Entity
Organization
Contact information
Practice address
903 HARTFORD TPKE UNIT 30, WATERFORD, CT 06385-4264
(860) 772-1998
(860) 772-1999
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
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
10/11/2019
Last updated
10/11/2019
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