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NEW YORK VASCULAR GROUP, PLLC
NPI 1073128971
Surgery - Vascular Surgery in Cornwall, NY

Active since September 09, 2020CLIA 33D2230630 · Waiver
19 LAUREL AVE STE 102, CORNWALL, NY 12518(845) 822-8100(845) 822-8110 Get Directions Write a Review

NPPES record last updated: February 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 19, 2023, Sep 23, 2020, Sep 16, 2020 and 1 more (4 updates tracked since 2020).

About New York Vascular Group, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEW YORK VASCULAR GROUP, PLLC (NPI 1073128971) is a healthcare organization registered as a vascular surgery in Cornwall, New York and active in the NPI registry since September 2020. The organization holds a CLIA Waiver certificate valid through July 26, 2027 and lists Sae Hahm, Owner, as its authorized official.

NPPES Registry Identity

NPI1073128971
Entity TypeOrganization
Primary Taxonomy2086S0129X
Legal Business NameNEW YORK VASCULAR GROUP, PLLC
Location Address19 LAUREL AVE STE 102Cornwall, NY 12518-1403
Mailing Address6 Research Dr Ste 105Shelton, CT 06484-6228 · (203) 210-6340 · Fax (203) 502-2615
Phone(845) 822-8100
Fax(845) 822-8110
Organization SubpartNo
Authorized OfficialSae HahmOwner · (203) 262-9979
Enumeration DateSeptember 9, 2020
Last NPPES UpdateFebruary 19, 20244 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2024
✔ NPI 1073128971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
19 LAUREL AVE STE 102, Cornwall, NY 12518
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2230630

New York Vascular Group PLLC · Cornwall, NY
Active · expires Jul 26, 2027
CLIA Number33D2230630
Laboratory TypePhysician Office
Certificate Effective DateJuly 27, 2025
Certificate Expiration DateJuly 26, 2027
Laboratory DirectorDr. Sae J. Hahm
Laboratory Phone(845) 822-8100
Laboratory LocationNew York Vascular Group PLLC19 Laurel Avenue Suite 102, Cornwall, NY 12518
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOHAMED YOUSEF ELSAGGA D.O.
Surgery (Vascular Surgery)
19 LAUREL AVE STE 102
CORNWALL, NY 12518
Orange County (845) 822-8100
SAE JOON HAHM M.D.
Surgery (Vascular Surgery)
19 LAUREL AVE STE 102
CORNWALL, NY 12518
Orange County (845) 822-8100
MS. JENNIFER ANN JACKSON RPAC
Physician Assistant (Surgical)
19 LAUREL AVE STE 102
CORNWALL, NY 12518
Orange County (845) 822-8100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is New York Vascular Group, PLLC's NPI number?

The NPI number for New York Vascular Group, PLLC is 1073128971. It was assigned to this organization in the NPPES registry on September 9, 2020.

Where is New York Vascular Group, PLLC located?

New York Vascular Group, PLLC is located at 19 Laurel Ave Ste 102, Cornwall, NY 12518. The listed phone number is (845) 822-8100.

What is New York Vascular Group, PLLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Does New York Vascular Group, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2230630) is associated with this NPI, valid through July 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for New York Vascular Group, PLLC was last updated on February 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.