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General NPI Number Information
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NPI Number | 1740510478
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Entity Type | Organization
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Legal Business Name | ASTORIA CARDIOVASCULAR SERVICES, PC
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 12/31/2009
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Provider Practice Location Address
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Address Line | 3503 31ST AVENUE
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City | ASTORIA
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State | NY
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Zip | 11106-1434
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Country | US
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Telephone | 718-932-2900
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Fax | 718-932-5115
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Provider Business Mailing Address
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Address Line | 3503 31ST AVE
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City | ASTORIA
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State | NY
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Zip | 11106-1434
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Country | US
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Telephone | 718-932-2900
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Fax | 718-932-5115
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Authorized Official
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Title or Position | CEO
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Name | DEMETRIOS GEORGIOU
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Credential | M.D.
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Telephone | 718-932-2900
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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 | 166154
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License Number State | NY
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