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General NPI Number Information
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NPI Number | 1164708574
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Entity Type | Organization
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Legal Business Name | MG CARDIOLOGY PLLC
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Dates
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Enumeration Date | 10/30/2011
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Last Update Date | 10/30/2011
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Provider Practice Location Address
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Address Line | 7823 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-2928
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Country | US
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Telephone | 718-326-1998
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Fax | 718-360-9648
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Provider Business Mailing Address
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Address Line | 11724 PARK LN S
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City | RICHMOND HILL
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State | NY
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Zip | 11418-1021
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Country | US
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Telephone | 718-850-7475
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Fax | 718-360-9648
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MITCHELL GEIZHALS
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Credential | M.D.
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Telephone | 718-326-1998
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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 | 164427
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License Number State | NY
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