Healthcare Provider Details

I. General information

NPI: 1013959725
Provider Name (Legal Business Name): LONG ISLAND CARDIOVASCULAR IMAGING CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 OHIO DR
NEW HYDE PARK NY
11042-1144
US

IV. Provider business mailing address

4 OHIO DR STE 220
NEW HYDE PARK NY
11042-1144
US

V. Phone/Fax

Practice location:
  • Phone: 516-627-2121
  • Fax: 516-627-4922
Mailing address:
  • Phone: 516-627-2121
  • Fax: 516-627-4922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH H COHEN
Title or Position: MD/PRESIDENT
Credential: MD
Phone: 516-627-5430