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General NPI Number Information
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NPI Number | 1467462978
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY CONSULTANTS OF LONG ISLAND, PC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 2000 NORTH VILLAGE AVE SUITE # 106-108
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-678-1444
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Fax | 516-678-1023
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Provider Business Mailing Address
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Address Line | 2000 NORTH VILLAGE AVE SUITE # 106-108
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-678-1444
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Fax | 516-678-1023
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Authorized Official
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Title or Position | PRESIDENT
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Name | THIERRY DUCHATELLIER
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Credential | MD
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Telephone | 516-678-1444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 206601
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 206601
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License Number State | NY
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