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General NPI Number Information
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NPI Number | 1962693820
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Entity Type | Organization
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Legal Business Name | AVENUE V CARDIOLOGY P.C
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 3025 AVENUE V
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City | BROOKLYN
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State | NY
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Zip | 11229-5448
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Country | US
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Telephone | 718-513-0966
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Fax | 718-513-1020
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Provider Business Mailing Address
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Address Line | 3025 AVENUE V
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City | BROOKLYN
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State | NY
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Zip | 11229-5448
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Country | US
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Telephone | 718-513-0966
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Fax | 718-513-1020
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Authorized Official
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Title or Position | OFFICER OF CORP
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Name | RAJEN MANIAR
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Credential |
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Telephone | 718-513-0966
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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 | 238838
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License Number State | NY
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