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General NPI Number Information
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NPI Number | 1033379557
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Entity Type | Organization
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Legal Business Name | CARDIAC IMAGING, PC
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 3671 SOUTHWESTERN BLVD SUITE 107
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1752
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Country | US
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Telephone | 716-667-2062
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Fax | 716-667-2063
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Provider Business Mailing Address
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Address Line | 908 NIAGARA FALLS BLVD SUITE 208
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City | N TONAWANDA
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State | NY
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Zip | 14120-2019
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Country | US
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Telephone | 716-692-3302
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Fax | 716-362-9518
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Authorized Official
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Title or Position | OWNER
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Name | DAVID AVINO
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Credential | MD
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Telephone | 716-667-2062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | 199233
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License Number State | NY
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