Healthcare Provider Details

I. General information

NPI: 1235192345
Provider Name (Legal Business Name): CHINATOWN CARDIOLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 CENTRE ST SUITE 307
NEW YORK NY
10013-4408
US

IV. Provider business mailing address

139 CENTRE ST SUITE 307
NEW YORK NY
10013-4408
US

V. Phone/Fax

Practice location:
  • Phone: 212-334-3507
  • Fax: 212-334-4728
Mailing address:
  • Phone: 212-334-3507
  • Fax: 212-334-4728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TAK W. KWAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 212-334-3507