Healthcare Provider Details

I. General information

NPI: 1285556951
Provider Name (Legal Business Name): CAPITAL CARDIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BALTIMORE PIKE
SPRINGFIELD PA
19064-3529
US

IV. Provider business mailing address

PO BOX 9369
PHILADELPHIA PA
19139-9369
US

V. Phone/Fax

Practice location:
  • Phone: 267-258-8852
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: SAMANTHA LADD
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 267-258-8852