Provider Demographics
NPI:1538571336
Name:ADVANCED VASCULAR TECHNOLOGIES, INC.
Entity type:Organization
Organization Name:ADVANCED VASCULAR TECHNOLOGIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:DULNIKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-919-4501
Mailing Address - Street 1:20 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 E 7TH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5230
Practice Address - Country:US
Practice Address - Phone:484-919-4501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4268957332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies