Basic Information
| Provider Information | |||||||||
| NPI: | 1245452812 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VASCULAR ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33O WASHINGTON STREET | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608898331 | ||||||||
| FaxNumber: | 8608870636 | ||||||||
| Practice Location | |||||||||
| Address1: | 33O WASHINGTON STREET | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608898331 | ||||||||
| FaxNumber: | 8608870636 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | AHAMED | ||||||||
| AuthorizedOfficialFirstName: | SULTAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 8606085810 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 015920 AND 011109 | CT | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.