Organization
VASCULAR DIAGNOSTICS OF LI PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LATEEF GIWA (MEDICAL DIRECTOR)
(516) 695-7172
Entity
Organization
Contact information
Practice address
283 COMMACK RD, SUITE 125, COMMACK, NY 11725-6021
(631) 499-3505
Mailing address
283 COMMACK RD, SUITE 125, COMMACK, NY 11725-6021
(631) 499-3505
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
119661
NY
208D00000X
General Practice Physician
119661
NY
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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