NEW YORK VASCULAR GROUP, PLLC (NPI# 1073128971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073128971 |
| Entity Type | Organization |
| Organization Name | NEW YORK VASCULAR GROUP, PLLC |
| Practice Address |
19 Laurel Ave Ste 102 Cornwall NY 12518-1403 |
| Mailing Address |
6 Research Dr Ste 105 Shelton CT 06484-6228 |
| Practice Telephone | 2032106340 |
| Mailing Telephone | 2032106340 |
| Mailing Fax Number | 2035022615 |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-23 |
| Authorized Official Name | SAE HAHM (OWNER) |
| Authorized Official Telephone | 2032629979 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | NEW YORK VASCULAR GROUP, PLLC | 19 Laurel Ave., Cornwall, NY 12518 |
| New York State Corporations | NEW YORK VASCULAR GROUP, PLLC | 6 Research Drive, Shelton, Ct 06464 |
| Street Address |
19 LAUREL AVE STE 102 |
| City | CORNWALL |
| State | NY |
| Zip Code | 12518-1403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548883697 | Rose Ema Francine Dubreus Pierre | Registered Nurse | 40 Firth Street, Cornwall, NY 12518 | 2020-05-23 |
| 1255847406 | Casey Marianne Undersinger | Occupational Therapist | 340 Hudson Street, Cornwall, NY 12518 | 2017-12-26 |
| 1629287107 | Clifford James Russ | Dentist | 41 Ridge Road, Cornwall, NY 12518 | 2007-05-22 |
| 1740687474 | Carolann Frances Furchi | Psychologist | 186 Main Street, Cornwall, NY 12518 | 2014-11-24 |
| 1952661274 | Kirti Joseph | Student in an Organized Health Care Education/Training Program | Hudson Vista Medical, PC, 21 Laurel Avenue, Suite 280, Cornwall, NY 12518 | 2012-05-21 |
| 1255564969 | Manita Sawhney | Internal Medicine | Hudson Vista Medical, PC, 21 Laurel Avenue, Suite 280, Cornwall, NY 12518 | 2009-08-27 |
| 1568583896 | Eastern Orange Ambulatory Surgery Center, LLC | Clinic/Center | 21 Laurel Ave, Suite 120, Cornwall, NY 12518 | 2007-04-03 |
| 1518022771 | Pelella Apothecary Inc | Pharmacy | 21 Laurel Ave, Ste 110, Cornwall, NY 12518 | 2006-12-27 |
| 1245327162 | Thomas V Robb | Surgery | 21 Laurel Ave, Suite 240, Cornwall, NY 12518 | 2006-10-10 |
| 1134233497 | Prestige Physicians Services, Pllc | Family Medicine | 164 Willow Ave, Cornwall, NY 12518 | 2006-08-17 |
| Find all providers in zip 12518 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
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| 1578190179 | Camilo Jose Martinez | Surgery | 23 S Howell Ave Ste H, Centereach, NY 11720-4445 | 2020-03-24 |
| 1407483399 | Interventional Medicine | Surgery | 1122a Coney Island Ave, Brooklyn, NY 11230-2307 | 2020-03-23 |
| 1487287975 | Syracuse Professional Medical Services of New York LLC | Surgery | 1101 Erie Blvd E Ste 201a, Syracuse, NY 13210-1144 | 2020-02-13 |
| 1457983181 | Syracuse Medical of New York LLC | Surgery | 1101 Erie Blvd E Ste 201b, Syracuse, NY 13210-1144 | 2020-02-11 |
| 1366914483 | Star Veins Centers PC | Surgery | 225 W 35th St Frnt 2, New York, NY 10001-1904 | 2018-12-31 |
| 1528547312 | Norwood Professional Medical Services of New York LLC | Surgery | 3487-89 Jerome Ave, Ste A, Bronx, NY 10468 | 2018-08-13 |
| 1336628130 | Norwood Medical of New York LLC | Surgery | 3487-89 Jerome Ave, Ste B, Bronx, NY 10468 | 2018-08-13 |
| 1003393299 | Bushwick Professional Medical Services of New York LLC | Surgery | 441 Knickerbocker Ave Ste A, Brooklyn, NY 11237-4508 | 2018-07-20 |
| 1720565922 | Bushwick Medical of New York LLC | Surgery | 441 Knickerbocker Ave Ste B, Brooklyn, NY 11237-4508 | 2018-07-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.