Organization
MARYLAND AND VIRGINIA PHLEBOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAN KATSNELSON MD (OWNER)
(847) 774-5300
Entity
Organization
Contact information
Practice address
9515 DEERECO RD STE 205, TIMONIUM, MD 21093-2153
(410) 252-6836
Mailing address
304 WAINWRIGHT DR STE 120, NORTHBROOK, IL 60062-1919
(847) 257-1244
(224) 235-4652
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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