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General NPI Number Information
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NPI Number | 1508401217
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Entity Type | Organization
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Legal Business Name | ATLANTIC CARDIOVASCULAR CARE PC
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 504 GRAMATAN AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10552-3009
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Country | US
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Telephone | 732-426-7948
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Fax |
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Provider Business Mailing Address
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Address Line | 504 GRAMATAN AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10552-3009
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Country | US
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Telephone | 732-426-7948
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Fax |
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Authorized Official
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Title or Position | CARDIOLOGIST
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Name | MADAY C GONZALEZ
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Credential | MD
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Telephone | 646-415-4122
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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 |
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License Number State |
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