Basic Information
Provider Information
NPI: 1902904980
EntityType: 2
ReplacementNPI:  
OrganizationName: THE VANISHING VEIN INC.
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Mailing Information
Address1: PO BOX 9137
Address2:  
City: BROOKLINE
State: MA
PostalCode: 024469137
CountryCode: US
TelephoneNumber: 8009270002
FaxNumber:  
Practice Location
Address1: 61 LINCOLN ST
Address2:  
City: FRAMINGHAM
State: MA
PostalCode: 017028264
CountryCode: US
TelephoneNumber: 5086268346
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/21/2006
LastUpdateDate: 08/22/2020
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AuthorizedOfficialLastName: DAVISON
AuthorizedOfficialFirstName: BRIAN
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AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 5086268346
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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