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General NPI Number Information
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NPI Number | 1346411808
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Entity Type | Organization
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Legal Business Name | QUEENS CARDIOVASCULAR PLLC
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 4503 KISSENA BLVD
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City | FLUSHING
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State | NY
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Zip | 11355-3429
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Country | US
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Telephone | 646-494-7281
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Fax | 877-249-6926
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Provider Business Mailing Address
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Address Line | 4503 KISSENA BLVD
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City | FLUSHING
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State | NY
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Zip | 11355-3429
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Country | US
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Telephone | 646-494-7281
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Fax | 877-249-6926
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Authorized Official
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Title or Position | CARDIOLOGIST
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Name | DR. VIVIEN LIM
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Credential | M.D.
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Telephone | 646-494-7281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 235491
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License Number State | NY
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