Healthcare Provider Details

I. General information

NPI: 1952463309
Provider Name (Legal Business Name): ADVANCED HEART PHYSICIANS&SURGEONS NETWORK PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E 77TH ST 4 FL
NEW YORK NY
10075-1851
US

IV. Provider business mailing address

130 E 77TH ST 4 FL
NEW YORK NY
10075-1851
US

V. Phone/Fax

Practice location:
  • Phone: 212-434-3000
  • Fax: 212-434-2837
Mailing address:
  • Phone: 212-434-3000
  • Fax: 212-434-2837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY R THORNTON
Title or Position: BILLING MANAGER
Credential:
Phone: 212-434-3222