Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 25MB11094600 | NJ |
NPI | 1053729988 |
---|---|
Provider Name | Kunal Vani |
First Address | Boston, MA 02241-6457 |
Second Address | Rockaway, NJ 07866-1657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 15/10/2021 |