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General NPI Number Information
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NPI Number | 1609241637
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Entity Type | Organization
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Legal Business Name | WESTCHESTER CARDIOVASCULAR PC
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Dates
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Enumeration Date | 12/02/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 1111 OCEAN AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-2039
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Country | US
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Telephone | 929-321-3684
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 AVENUE K
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City | BROOKLYN
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State | NY
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Zip | 11230-4117
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Country | US
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Telephone | 929-321-3684
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DMITRY GORELIK
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Credential | MD
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Telephone | 929-321-3684
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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 | 238300-1
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License Number State | MD
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