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General NPI Number Information
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NPI Number | 1700083235
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Entity Type | Organization
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Legal Business Name | CLINICAL AND INTERVENTIONAL CARDIOLOGY PLLC
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 140A LOCKWOOD AVENUE
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-4920
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Country | US
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Telephone | 914-576-7577
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Fax | 914-576-7377
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Provider Business Mailing Address
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Address Line | 140A LOCKWOOD AVENUE
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City | NEW ROCHELLE
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State | NY
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Zip | 10801
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Country | US
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Telephone | 914-576-7577
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Fax | 914-576-7377
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | LYNNE V PERRY-BOTTINGER
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Credential | MD
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Telephone | 914-576-7577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 2066371
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License Number State | NY
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