Associates in Vascular Care LLC Limb Salvage Center

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

25MA08547000 Issued in NJ

Legal business name

ASSOCIATES IN VASCULAR CARE LLC LIMB SALVAGE CENTER

Practice address

1000 Route 35 South
Suite 300
Middletown, NJ 07748-2606

Phone

(732) 784-6550

Fax

(732) 737-9836

NPI assigned

Sep 9, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Owano Pennycooke, MD

Title

President

Phone

(732) 784-6550

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1023486925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HIGHWAY 9 NORTH",
            "address_2": "SUITE 224",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-784-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ROUTE 35 SOUTH",
            "address_2": "SUITE 300",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482606",
            "telephone_number": "732-784-6550",
            "fax_number": "732-737-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN VASCULAR CARE LLC LIMB SALVAGE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "PENNYCOOKE",
        "authorized_official_first_name": "OWANO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-784-6550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA08547000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Middletown, NJ
• Providers in Middletown, NJ by specialty
• Vascular Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.