| Organization Name: | VASCULAR DIAGNOSTICS OF LI PC |
| NPI Number: | 1366743239 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LATEEF GIWA (MEDICAL DIRECTOR) |
| Mailing Address: | 283 Commack Rd Suite 125 Commack |
| State: | NY US |
| Postal Code: | 117256021 |
| Phone Number: | 6314993505 |
| Fax Number: | |
| NPI Enumeration Date: | 11/09/2010 |
| NPI Last Update Date: | 11/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 119661 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |