Healthcare Provider Details
I. General information
NPI: 1972701985
Provider Name (Legal Business Name): HIGH QUALITY CARDIOVASCULAR DIAGNOSTICS OF BROOKLYN, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2007
Last Update Date: 08/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9520 SEAVIEW AVE
BROOKLYN NY
11236-5466
US
IV. Provider business mailing address
9520 SEAVIEW AVE
BROOKLYN NY
11236-5466
US
V. Phone/Fax
- Phone: 718-241-4474
- Fax:
- Phone: 718-241-4474
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 148235 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | 148235 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
KHALID
KAMAL
HASSAN
Title or Position: OWNER
Credential: M.D.
Phone: 718-241-4474