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Contact Information

CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC
7900 W JEFFERSON BLVD
SUITE 303
FORT WAYNE, IN46804-4128
 Phone: 260-436-6098
 Fax: 260-436-3173
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC

NPI # 1083684948
LBN Legal business name CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC
Authorized official JOHN CSICSKO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/24/2006
Last updated 11/28/2011 - About 15 years ago
Identifiers
IN Medicaid 200049160A
IN Other CA5617 TAVELERS MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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