MEDICARE: GRAMERCY CARDIAC DIAGNOSTIC SVCS 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	207UN0901X	Nuclear Cardiology Physician	60-144465	NY

General Provider Information

NPI Number	:	1699942227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAMERCY CARDIAC DIAGNOSTIC SVCS P.C.

Provider Business Mailing Address
First Line	:	PO BOX 9467
Second Line	:
City	:	UNIONDALE
State	:	NY
Zip	:	11555-9467
Country	:	US
Telephone Number	:	212-475-8066
Fax Number	:	212-475-4175

Provider Business Practice Location Address
First Line	:	11014 JAMAICA AVE
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-2320
Country	:	US
Telephone Number	:	212-475-8066
Fax Number	:	212-475-4175

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NORA FLEISCHMANN
Credential	:
Telephone Number	:	212-475-8066

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	10/31/2017

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