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General NPI Number Information
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NPI Number | 1528349099
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR PREVENTION AND THERAPEUTICS OF NY, PLLC
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Dates
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Enumeration Date | 08/29/2011
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 133 E 58TH ST SUITE 301/304
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City | NEW YORK
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State | NY
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Zip | 10022-1236
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Country | US
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Telephone | 212-755-8700
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Fax | 212-755-5342
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Provider Business Mailing Address
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Address Line | 133 E 58TH ST SUITE 301/304
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City | NEW YORK
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State | NY
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Zip | 10022-1236
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Country | US
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Telephone | 212-755-8700
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Fax | 212-755-5342
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES ALAN BLAKE
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Credential | M.D.
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Telephone | 212-755-8700
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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 | 150380
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License Number State | NY
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