Main Line Vascular Institute LLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

MAIN LINE VASCULAR INSTITUTE LLC

Practice address

700 S Henderson Rd
Suite 304a
King of Prussia, PA 19406-3530

Phone

(215) 382-3680

NPI assigned

Apr 23, 2015

Organization subpart

No

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

Authorized official

Name

James F McGuckin, MD

Title

Ceo

Phone

(215) 382-3680

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1194112573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S HENDERSON RD STE 225",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063530",
            "telephone_number": "215-382-3680",
            "fax_number": "215-240-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S HENDERSON RD",
            "address_2": "SUITE 304A",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063530",
            "telephone_number": "215-382-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE VASCULAR INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "MCGUCKIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-382-3680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ellen Mahoney, DPT
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• Bethany Maldonado
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• Bushra I Malik, MD
• Xhulia Maloku, BCBA

• Vascular & Interventional Radiology Physician in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Vascular & Interventional Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.