Eastern Vascular LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EASTERN VASCULAR LLC

Practice address

16 Pocono Rd
Suite 313
Denville, NJ 07834-2901

Phone

(973) 625-0112

Fax

(973) 625-0721

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Lee Mintz, DONPI 1508834169

Title

President

Phone

(973) 625-0112

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Bruce Lee Mintz, DO

  • Internal Medicine Physician
  • Denville, NJ
  • NPI 1508834169
  NPD (past) Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1609960418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 POCONO RD",
            "address_2": "SUITE 313",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342901",
            "telephone_number": "973-625-0112",
            "fax_number": "973-625-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 POCONO RD",
            "address_2": "SUITE 313",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342901",
            "telephone_number": "973-625-0112",
            "fax_number": "973-625-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN VASCULAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "MINTZ",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-625-0112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr Danielle Ager DC
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• Lee A. Ecker, DDS
• Anna Egorova, RN, APN
• Franklin Chinezimuzo Ejeagha, M.B.B.S
• Uchenna Elenwune, DPT
• Richard Elepano, D.O.

• Internal Medicine Physician in Denville, NJ
• Providers in Denville, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.