MEDICARE: WINTHROP CARDIOVASCULAR & THORACIC SURGERY, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	106580	NY
2	2086S0129X	Vascular Surgery Physician	194340	NY
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	185586	NY
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	124484	NY
5	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	190141	NY
6	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	201051	NY
7	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	106580	NY

General Provider Information

NPI Number	:	1518026400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINTHROP CARDIOVASCULAR & THORACIC SURGERY, PC

Provider Business Mailing Address
First Line	:	120 MINEOLA BLVD., SUITE 300
Second Line	:
City	:	MINEOLA
State	:	NY
Zip	:	11501
Country	:	US
Telephone Number	:	516-663-4400
Fax Number	:	516-663-4404

Provider Business Practice Location Address
First Line	:	120 MINEOLA BLVD STE 300
Second Line	:
City	:	MINEOLA
State	:	NY
Zip	:	11501-4077
Country	:	US
Telephone Number	:	516-663-4400
Fax Number	:	516-663-4404

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MS. PATRICIA HAWORTH
Credential	:
Telephone Number	:	516-663-4400

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	11/06/2009

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