Mid-Atlantic Vein and Vascular Institute LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MID-ATLANTIC VEIN AND VASCULAR INSTITUTE LLC

Practice address

5600 Chestnut St
Philadelphia, PA 19139-3232

Phone

(267) 252-6408

NPI assigned

Sep 12, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Haytham Albizem, MDNPI 1467442285

Title

President

Phone

(267) 252-6408

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Haytham Albizem, MD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1467442285
  Authorized official Same address or phone

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1134779093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393232",
            "telephone_number": "267-252-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393232",
            "telephone_number": "267-252-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC VEIN AND VASCULAR INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "ALBIZEM",
        "authorized_official_first_name": "HAYTHAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-252-6408",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Micklow
• Matthew Adam Miclette, RN
• Amanda Catherine Micucio, D.O.
• Mid Atlantic Rehabilitation Services
• Mid-Atlantic Rehabilitation Services, Inc
• Midatlantic Medevac LLC (MidAtlantic MedEvac)
• Middle Ground Solutions LLC
• Lynne Middleberg-Warszawski, RPH
• Harold L Middleberg, DMD
• Jordyn Middleberg, DMD

• Ambulatory Surgical Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.