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General NPI Number Information
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NPI Number | 1376952804
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Entity Type | Organization
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Legal Business Name | ST. FRANCIS CARDIAC PREVENTION SERVICES PC
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 245 OLD COUNTRY RD
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City | MELVILLE
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State | NY
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Zip | 11747-2726
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Country | US
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Telephone | 631-465-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 245 OLD COUNTRY RD
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City | MELVILLE
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State | NY
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Zip | 11747-2726
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Country | US
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Telephone | 631-465-6001
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LORRAINE HUMMEL
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Credential |
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Telephone | 631-465-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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