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General NPI Number Information
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NPI Number | 1588040752
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Entity Type | Organization
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Legal Business Name | NEW YORK CARDIOVASCULAR CARE AND PREVENTIVE INTERVENTIONS PLLC
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 240 WILLOUGHBY ST SUITE 10F
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City | BROOKLYN
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State | NY
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Zip | 11201-5465
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Country | US
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Telephone | 718-783-7001
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Fax | 718-783-7091
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Provider Business Mailing Address
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Address Line | PO BOX 26003
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City | BROOKLYN
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State | NY
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Zip | 11202-6003
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Country | US
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Telephone | 718-783-7001
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Fax | 718-783-7091
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | CARLOS RODRIGUEZ
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Credential | M.D
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Telephone | 718-614-9297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 212389
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License Number State | NY
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