MEDICARE: PREVENTIVE CARDIOLOGY OF NEW YORK P.C.

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1467052159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREVENTIVE CARDIOLOGY OF NEW YORK P.C.

Provider Business Mailing Address
First Line	:	1335 OCEAN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5655
Country	:	US
Telephone Number	:	718-375-1600
Fax Number	:	718-375-3408

Provider Business Practice Location Address
First Line	:	1335 OCEAN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5655
Country	:	US
Telephone Number	:	718-375-1600
Fax Number	:	718-375-3408

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT PRESS
Credential	:	M.D.
Telephone Number	:	718-283-8648

Provider Enumeration Date	:	10/30/2020
Last Update Date	:	02/26/2021

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