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General NPI Number Information
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NPI Number | 1528482338
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Entity Type | Organization
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Legal Business Name | HEART & VASCULAR MEDICINE, P. C.
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 12/15/2014
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Provider Practice Location Address
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Address Line | 14220 FRANKLIN AVE STE LB
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City | FLUSHING
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State | NY
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Zip | 11355-2619
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Country | US
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Telephone | 718-886-4608
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Fax | 718-886-4609
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Provider Business Mailing Address
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Address Line | 6632 ALDERTON ST
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City | REGO PARK
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State | NY
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Zip | 11374-5206
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Country | US
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Telephone | 718-886-4608
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Fax | 718-886-4609
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Authorized Official
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Title or Position | OFFICER
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Name | QIAN ZHAO
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Credential | M. D.
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Telephone | 718-886-4608
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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 | 256763
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License Number State | NY
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