Complete Vascular Inc

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

25MA07266800 Issued in NJ

Legal business name

COMPLETE VASCULAR INC

Practice address

25 Rockwood PL
Suite #425
Englewood, NJ 07631-4957

Phone

(201) 569-1101

Fax

(201) 567-4039

NPI assigned

Aug 1, 2012

Last updated

Aug 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theresa Maria Impeduglia, MD

Title

Ceo

Phone

(201) 658-5882

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JEFABA

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1861748444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROCKWOOD PL",
            "address_2": "SUITE #425",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314957",
            "telephone_number": "201-569-1101",
            "fax_number": "201-567-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ROCKWOOD PL",
            "address_2": "SUITE #425",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314957",
            "telephone_number": "201-569-1101",
            "fax_number": "201-567-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE VASCULAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "IMPEDUGLIA",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-658-5882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA07266800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.