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General NPI Number Information
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NPI Number | 1851361844
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY ASSOCIATES OF DERBY PC
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 130 DIVISION ST
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City | DERBY
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State | CT
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Zip | 06418
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Country | US
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Telephone | 203-732-7455
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Fax | 203-735-5507
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Provider Business Mailing Address
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Address Line | PO BOX 354
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City | DERBY
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State | CT
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Zip | 06418
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Country | US
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Telephone | 203-732-7455
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Fax | 203-735-5507
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENNETH V SCHWARTZ
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Credential | MD
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Telephone | 203-732-7455
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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 |
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License Number State |
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