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General NPI Number Information
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NPI Number | 1003034869
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Entity Type | Organization
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Legal Business Name | BLACKSTONE CARDIOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 333 SCHOOL ST SUITE 112
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City | PAWTUCKET
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State | RI
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Zip | 02860-5334
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Country | US
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Telephone | 401-723-1210
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Fax | 401-312-2099
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Provider Business Mailing Address
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Address Line | 333 SCHOOL ST SUITE 112
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City | PAWTUCKET
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State | RI
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Zip | 02860-5334
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Country | US
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Telephone | 401-723-1210
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Fax | 401-312-2099
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW R HORDES
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Credential | M.D.
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Telephone | 401-723-1210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NPP36181
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License Number State | RI
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