Provider Demographics
NPI:1538573837
Name:THE VEIN CENTER AT EDEN HILL LLC
Entity type:Organization
Organization Name:THE VEIN CENTER AT EDEN HILL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDT
Authorized Official - Middle Name:J
Authorized Official - Last Name:FEUERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-735-8850
Mailing Address - Street 1:200 BANNING ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3488
Mailing Address - Country:US
Mailing Address - Phone:302-735-8850
Mailing Address - Fax:302-735-8851
Practice Address - Street 1:200 BANNING ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3485
Practice Address - Country:US
Practice Address - Phone:302-735-8850
Practice Address - Fax:302-735-8851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006274208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1538573837OtherNPI