ELYSIUM AESTHETICS AND VEIN CARE INC NPI 1952764862

NPI Information

NPI: 1952764862
Provider Name: ELYSIUM AESTHETICS AND VEIN CARE, INC
Classification: Radiology - 2085R0204X
Entity Type: Organization

Specialization: Vascular & Interventional Radiology

Address:
400 STATE ROUTE 17
RIDGEWOOD, NJ
ZIP 07450
Phone: (518) 852-8114
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ELYSIUM AESTHETICS AND VEIN CARE, INC is a vascular and interventional radiology radiology in Ridgewood, NJ. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. ELYSIUM AESTHETICS AND VEIN CARE, INC NPI is 1952764862. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

400 STATE ROUTE 17
RIDGEWOOD, NJ
ZIP 07450
Phone: (518) 852-8114
Fax: (866) 339-2822

The provider's authorized official is David Singh .
The authorized official title is Owner and has the following contact phone number (518) 852-8114.

The enumeration date for this NPI number is 3/30/2016 and was last updated on 6/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0204X	Radiology	Vascular & Interventional Radiology	25MA08769000	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	J40005623	MEDICARE PIN	NEW YORK
2	0242039	MEDICAID	NEW JERSEY
3	191723ZFPU	MEDICARE PIN	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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