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General NPI Number Information
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NPI Number | 1396960696
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Entity Type | Organization
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Legal Business Name | CAREHEART CARDIOLOGY PC
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 5225 NESCONSET HWY SUITE 37
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-2053
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Country | US
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Telephone | 631-642-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 5225 NESCONSET HWY SUITE 37
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-2053
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Country | US
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Telephone | 631-642-1500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHUG-HONG YOUNG
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Credential | MD
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Telephone | 631-642-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 143130
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License Number State | NY
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