Healthcare Provider Details

I. General information

NPI: 1679558654
Provider Name (Legal Business Name): VAZZANA&BOGIN CARDIOLOGY ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SEAVIEW AVE SUITE200
STATEN ISLAND NY
10305-3436
US

IV. Provider business mailing address

501 SEAVIEW AVE SUITE200
STATEN ISLAND NY
10305-3436
US

V. Phone/Fax

Practice location:
  • Phone: 718-663-6400
  • Fax: 718-663-6490
Mailing address:
  • Phone: 718-663-6400
  • Fax: 718-663-6490

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: DR. THOMAS JOHN VAZZANA
Title or Position: OWNER
Credential: MD
Phone: 718-663-6400