Center for Vein Restoration MD LLC
Organization Active NPI Vascular Surgery Physician · Hagerstown, MD
NPI 1023830320 · NPPES record last updated Oct 28, 2024
Key facts
- NPI
- 1023830320
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- Legal business name
- CENTER FOR VEIN RESTORATION MD LLC
- Practice address
- 1401 Dual Hwy
Hagerstown, MD 21740-6568 - Phone
- (855) 830-8346
- Fax
- (240) 473-4321
- NPI assigned
- Oct 28, 2024
- Organization subpart
- No
Authorized official
- Name
- Lorena Thomas
- Title
- Credentialing Manager
- Phone
- (815) 254-1761
Corporate family (same tax ID) 35
Practitioners 1
-
Sanjiv Lakhanpal, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250918000515 | MD | DME Supplier - Physician - Thoracic Surgery | 8729022736 | Practice locations: Hagerstown, MD |
National Provider Directory
- Tax ID family
- Center for Vein Restoration
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician |
2086S0129X | Yes |
Addresses
Primary practice location
1401 Dual Hwy
Hagerstown, MD 21740-6568
Mailing address
7474 Greenway Center Dr Ste 1000
Greenbelt, MD 20770-3500
Phone (815) 254-1761
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- Centers for Advanced ENT Care, LLC
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All providers in Hagerstown, MD · Vascular Surgery Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.