Healthcare Provider Details

I. General information

NPI: 1174674808
Provider Name (Legal Business Name): NORTH NASSAU CARDIOLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 GLEN STREET SUITE 200
GLEN COVE NY
11542-2854
US

IV. Provider business mailing address

70 GLEN STREET SUITE 200
GLEN COVE NY
11542-2854
US

V. Phone/Fax

Practice location:
  • Phone: 516-484-7893
  • Fax:
Mailing address:
  • Phone: 516-484-7893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CARL SCHREIBER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 516-484-7893