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General NPI Number Information
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NPI Number | 1154098036
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Entity Type | Organization
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Legal Business Name | HEART AND HEALTH MEDICAL PLLC
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 6175 SUNRISE HWY
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City | MASSOPEQUA
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State | NY
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Zip | 11758
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Country | US
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Telephone | 516-643-4654
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Fax | 631-482-1356
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Provider Business Mailing Address
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Address Line | 21 LEROY STREET
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City | DIX HILLS
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State | NY
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Zip | 11746
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Country | US
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Telephone | 516-643-4654
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Fax | 631-482-1356
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Authorized Official
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Title or Position | MD MANAGING PARTNER.
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Name | DAVID KAVESTEEN
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Credential | MD
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Telephone | 516-643-4654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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