Healthcare Provider Details

I. General information

NPI: 1982262440
Provider Name (Legal Business Name): ISLAND CARDIOVASCULAR SURGERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3556 RICHMOND AVE
STATEN ISLAND NY
10312-3253
US

IV. Provider business mailing address

3556 RICHMOND AVE
STATEN ISLAND NY
10312-3253
US

V. Phone/Fax

Practice location:
  • Phone: 718-227-8346
  • Fax:
Mailing address:
  • Phone: 718-227-8346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN ZARCONE
Title or Position: CEO
Credential: MD
Phone: 718-227-8346