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General NPI Number Information
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NPI Number | 1326194176
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Entity Type | Organization
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Legal Business Name | BRONXVILLE CARDIOLOGY ASSOCIATES
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 PONDFIELD RD W
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City | BRONXVILLE
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State | NY
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Zip | 10708-2666
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Country | US
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Telephone | 914-793-1606
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Fax | 914-793-1837
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Provider Business Mailing Address
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Address Line | 1 PONDFIELD RD W
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City | BRONXVILLE
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State | NY
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Zip | 10708-2666
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Country | US
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Telephone | 914-793-1606
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Fax | 914-793-1837
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Authorized Official
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Title or Position | VP
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Name | DR. MATILDA MARY TADDEO
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Credential | M.D.
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Telephone | 914-793-1606
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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 | 168065
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License Number State | NY
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