MEDICARE: CARDIAC EVALUATION SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1184675506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIAC EVALUATION SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 727
Second Line	:
City	:	WINDSOR
State	:	CT
Zip	:	06095-0727
Country	:	US
Telephone Number	:	800-367-1095
Fax Number	:	860-602-4749

Provider Business Practice Location Address
First Line	:	2063 SOUTH 116TH STREET
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53227
Country	:	US
Telephone Number	:	800-876-1919
Fax Number	:	414-545-4126

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	MR. ROBERT E SASS JR.
Credential	:
Telephone Number	:	860-298-6100

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	08/22/2020

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