Healthcare Provider Details
I. General information
NPI: 1699287201
Provider Name (Legal Business Name): HEART & RHYTHM CENTERS OF EXCELLENCE, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2017
Last Update Date: 11/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1623 FLATBUSH AVE STE 110
BROOKLYN NY
11210-3259
US
IV. Provider business mailing address
1623 FLATBUSH AVE STE 110
BROOKLYN NY
11210-3259
US
V. Phone/Fax
- Phone: 646-671-9252
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AZRIEL
AVEZBADALOV
Title or Position: DIRECTOR
Credential:
Phone: 646-671-9252