Provider Demographics
NPI:1447627401
Name:PERFUSION ASSOCIATES
Entity type:Organization
Organization Name:PERFUSION ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER /PERFUSIONIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:CCP
Authorized Official - Phone:480-659-6964
Mailing Address - Street 1:2753 E BROADWAY RD # 101-454
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-1579
Mailing Address - Country:US
Mailing Address - Phone:480-659-6964
Mailing Address - Fax:480-659-6791
Practice Address - Street 1:2753 E BROADWAY RD # 101-454
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-1579
Practice Address - Country:US
Practice Address - Phone:480-659-6964
Practice Address - Fax:480-659-6791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionistGroup - Single Specialty