Healthcare Provider Details

I. General information

NPI: 1417393331
Provider Name (Legal Business Name): EMPIRE CARDIOVASCULAR, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2013
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 HILTON AVE SUITE 105
HEMPSTEAD NY
11550-8115
US

IV. Provider business mailing address

230 HILTON AVE SUITE 105
HEMPSTEAD NY
11550-8115
US

V. Phone/Fax

Practice location:
  • Phone: 516-483-6440
  • Fax: 516-483-6439
Mailing address:
  • Phone: 516-483-6440
  • Fax: 516-483-6439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number251309
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number251309
License Number StateNY

VIII. Authorized Official

Name: DR. SIDHARTH YADAV
Title or Position: PRESIDENT
Credential: D.O.
Phone: 516-978-6634