Healthcare Provider Details

I. General information

NPI: 1124126917
Provider Name (Legal Business Name): CARDIOVASCULAR ASSOCIATES OF NEW YORK, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44-01 FRANCIS LEWIS BOULEVARD
BAYSIDE NY
11361-3002
US

IV. Provider business mailing address

PO BOX 610613
BAYSIDE NY
11361-0613
US

V. Phone/Fax

Practice location:
  • Phone: 718-423-3355
  • Fax: 718-423-3721
Mailing address:
  • Phone: 718-717-0233
  • Fax: 718-717-0265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL P. DOYLE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 718-717-0281