Organization
COSMETIC VEIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE FRANCES CHUBACK PH.D. (PRACTICE ADMINISTRATOR)
(201) 445-8820
Entity
Organization
Contact information
Practice address
265 ACKERMAN AVE, SUITE 203, RIDGEWOOD, NJ 07450-4200
(201) 445-8820
(201) 445-8850
Mailing address
265 ACKERMAN AVENUE, SUITE 203, RIDGEWOOD, NJ 07450-0745
(201) 445-8820
(201) 445-8850
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
03/29/2007
Last updated
10/04/2007
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