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General NPI Number Information
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NPI Number | 1154392132
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR CLINICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 17880 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3104
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Country | US
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Telephone | 248-615-7300
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Fax | 248-615-7333
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Provider Business Mailing Address
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Address Line | 17880 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3104
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Country | US
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Telephone | 248-615-7300
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Fax | 248-615-7333
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MELISA PALENTINO
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Credential |
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Telephone | 248-615-7315
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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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