MEDICARE: CARDIOVASCULARTECHS 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	246XS1301X	Sonography Specialist/Technologist Cardiovascular		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1144281973	OTHER	NY	NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558899476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOVASCULARTECHS INC.

Provider Business Mailing Address
First Line	:	4064 BRUNER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2229
Country	:	US
Telephone Number	:	917-557-4844
Fax Number	:

Provider Business Practice Location Address
First Line	:	4064 BRUNER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2229
Country	:	US
Telephone Number	:	917-557-4844
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GEORGE MINIX
Credential	:	RCS
Telephone Number	:	917-557-4844

Provider Enumeration Date	:	05/23/2017
Last Update Date	:	07/21/2022

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