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General NPI Number Information
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NPI Number | 1164664942
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Entity Type | Organization
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Legal Business Name | HEART DOCS LLP
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Dates
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Enumeration Date | 03/25/2009
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Last Update Date | 03/25/2009
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Provider Practice Location Address
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Address Line | 6410 VETERANS AVE SUITE 102
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City | BROOKLYN
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State | NY
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Zip | 11234-5639
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Country | US
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Telephone | 718-763-7061
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Fax | 718-763-3045
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Provider Business Mailing Address
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Address Line | 6410 VETERANS AVE SUITE 102
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City | BROOKLYN
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State | NY
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Zip | 11234-5639
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Country | US
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Telephone | 718-763-7061
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Fax | 718-763-3045
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Authorized Official
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Title or Position | DR.
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Name | DR. DAVID AN MOO RIM
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Credential | M.D
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Telephone | 718-763-7061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 129036
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License Number State | NY
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