Healthcare Provider Details

I. General information

NPI: 1558877183
Provider Name (Legal Business Name): CARDIAC CARE OF NY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WATERS PL STE 308
BRONX NY
10461-2729
US

IV. Provider business mailing address

1200 WATERS PL STE 308
BRONX NY
10461-2729
US

V. Phone/Fax

Practice location:
  • Phone: 718-881-1447
  • Fax: 718-881-6099
Mailing address:
  • Phone: 718-881-1447
  • Fax: 718-881-6099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ILYA KAPLAN
Title or Position: PARTNER
Credential: MD
Phone: 718-881-1447