MEDICARE: COMPREHENSIVE CARDIAC SERVICES OF NY, PC

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	174400000X	Specialist	215488	NY

General Provider Information

NPI Number	:	1245325489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE CARDIAC SERVICES OF NY, PC

Provider Business Mailing Address
First Line	:	825 57TH ST
Second Line	:	SUITE 102
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3648
Country	:	US
Telephone Number	:	718-686-7300
Fax Number	:	718-633-2230

Provider Business Practice Location Address
First Line	:	825 57TH ST
Second Line	:	SUITE 102
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3648
Country	:	US
Telephone Number	:	718-686-7300
Fax Number	:	718-633-2230

Authorized Official
Title or Position	:	TREASURER
Name	:	APOSTOLOS ATHANASIOS VOUDOURIS
Credential	:	M.D.
Telephone Number	:	718-686-7300

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	08/22/2020

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