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UPSTATE VASCULAR STUDY LAB INC NPI 1194782938


NPI Information

NPI: 1194782938
Provider Name: UPSTATE VASCULAR STUDY LAB, INC

Former Legal Business Name: UPSTATE VASCULAR STUDY LAB

Classification: Physiological Laboratory - 293D00000X
Entity Type: Organization
Address:
2655 RIDGEWAY AVENUE
SUITE # 260
ROCHESTER, NY
ZIP 14626
Phone: (585) 720-0818
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UPSTATE VASCULAR STUDY LAB, INC is a physiological laboratory in Rochester, NY. The provider is a laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. UPSTATE VASCULAR STUDY LAB, INC NPI is 1194782938. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Upstate Vascular Study Lab.

The provider's business location address is:

2655 RIDGEWAY AVENUE
SUITE # 260
ROCHESTER, NY
ZIP 14626
Phone: (585) 720-0818
Fax: (585) 720-5427

The provider's authorized official is Tiffany A. Burgen .
The authorized official title is Office Manager and has the following contact phone number (585) 720-0818.

The enumeration date for this NPI number is 4/26/2006 and was last updated on 2/6/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1293D00000XPhysiological Laboratory124377NEW YORKYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100446135MEDICAIDNEW YORK
2AA1519MEDICARE ID-TYPE UNSPECIFIEDNEW YORK

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: 4/28/2024

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