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Contact Information

ELYSIUM AESTHETICS AND VEIN CARE, INC
400 STATE ROUTE 17
RIDGEWOOD, NJ07450
 Phone: 518-852-8114
 Fax: 866-339-2822
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for ELYSIUM AESTHETICS AND VEIN CARE INC · (Female)

NPI # 1952764862
Status Active
Credentials
Entity Individual
Enumeration date 03/30/2016
Last updated 06/03/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • NJ License # 25MA08769000
  • NJ Medicaid 0242039
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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