Healthcare Provider Details

I. General information

NPI: 1194768861
Provider Name (Legal Business Name): CARDIOVASCULAR HEALTHCARE CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W LANCASTER AVE PAOLI MEDICAL BLDG 3 SUITE 234
PAOLI PA
19301
US

IV. Provider business mailing address

255 W LANCASTER AVE PAOLI MEDICAL BLDG 3 SUITE 234
PAOLI PA
19301
US

V. Phone/Fax

Practice location:
  • Phone: 610-647-4260
  • Fax: 610-647-7430
Mailing address:
  • Phone: 610-647-4260
  • Fax: 610-647-7430

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: STEVEN M LAPORTE
Title or Position: PRESIDENT
Credential: MD
Phone: 610-647-4260