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General NPI Number Information
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NPI Number | 1215042213
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Entity Type | Organization
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Legal Business Name | ASSOCIATED CARDIOLOGY CONSULTANT PC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 10120 LEFFERTS BLVD
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-2006
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Country | US
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Telephone | 718-850-0707
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Fax | 718-850-9405
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Provider Business Mailing Address
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Address Line | 37 CLIFTON ST
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City | FARMINGDALE
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State | NY
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Zip | 11735-5500
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Country | US
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Telephone | 631-777-3155
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Fax | 631-777-3154
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Authorized Official
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Title or Position | MD
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Name | SHAIK ALI
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Credential | MD
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Telephone | 718-850-0707
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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 | 192787
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License Number State | NY
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