Organization Active NPI

Heritage Vascular Services PC

  • Family Medicine Physician
  • Bayonne, NJ
National Provider Identifier
1598537623
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE VASCULAR SERVICES PC
Practice address
421 Broadway
Bayonne, NJ 07002-3627
Phone
(973) 557-3351
NPI assigned
Oct 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Authorized official

Name
Dr. Aleksandr Martirosov, DONPI 1700931185
Title
Owner
Phone
(973) 557-3351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

421 Broadway
Bayonne, NJ 07002-3627

Mailing address

663 E Crescent Ave Ste 111
Ramsey, NJ 07446-1220
Phone (973) 557-3351

National Provider Directory

National Provider Directory

Locations

663 E Crescent Ave
Ste 111
Ramsey, NJ 07446
Phone (201) 283-4363

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1598537623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 E CRESCENT AVE STE 111",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461220",
            "telephone_number": "973-557-3351",
            "fax_number": "201-350-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023627",
            "telephone_number": "973-557-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VASCULAR SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "MARTIROSOV",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-557-3351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.