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NPI Code Detail

MEDICARE: ICARDIAC TECHNOLOGIES, INC.

MEDICARE: ICARDIAC TECHNOLOGIES, 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
1174400000XSpecialist

General Provider Information

NPI Number : 1720227804
Entity Type Code : Organization
Provider Name (Legal Business Name) : ICARDIAC TECHNOLOGIES, INC.
Provider Business Mailing Address
First Line : 150 ALLENS CREEK RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-3308
Country : US
Telephone Number : 585-295-7610
Fax Number : 585-295-7609
Provider Business Practice Location Address
First Line : 150 ALLENS CREEK RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-3308
Country : US
Telephone Number : 585-295-7610
Fax Number : 585-295-7609
Authorized Official
Title or Position : CEO
Name : J. MIKAEL TOTTERMAN
Credential :
Telephone Number : 585-295-7610
Provider Enumeration Date : 02/12/2009
Last Update Date : 02/12/2009

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