Healthcare Provider Details

I. General information

NPI: 1154863876
Provider Name (Legal Business Name): THROGS NECK CARDIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2016
Last Update Date: 09/21/2020
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3594 E TREMONT AVE STE 100
BRONX NY
10465-2032
US

IV. Provider business mailing address

3594 E TREMONT AVE STE 100
BRONX NY
10465-2032
US

V. Phone/Fax

Practice location:
  • Phone: 718-534-0689
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: ELENA LORRANINE VEZZA
Title or Position: OWNER
Credential:
Phone: 718-964-6161