Long Island Vascular and Endovascular Surgery PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

237254 Issued in NY

Legal business name

LONG ISLAND VASCULAR AND ENDOVASCULAR SURGERY PC

Practice address

300 E Main St
Suite 2
Smithtown, NY 11787-2900

Phone

(631) 298-7720

Fax

(631) 298-7721

NPI assigned

Feb 3, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Gustavo Torres, MD

Title

Owner

Phone

(631) 298-7720

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239926400000",
    "number": "1588802292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ROUTE 111",
            "address_2": "SUITE 315",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873738",
            "telephone_number": "631-298-7720",
            "fax_number": "631-298-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST",
            "address_2": "SUITE 2",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872900",
            "telephone_number": "631-298-7720",
            "fax_number": "631-298-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND VASCULAR AND ENDOVASCULAR SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-04-17",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-298-7720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "237254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.