MEDICARE: UTOPIA HEARTCARE PLLC

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	160413	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750570628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UTOPIA HEARTCARE PLLC

Provider Business Mailing Address
First Line	:	21116 UNION TPKE
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-3241
Country	:	US
Telephone Number	:	718-217-0500
Fax Number	:	718-217-0533

Provider Business Practice Location Address
First Line	:	21116 UNION TPKE
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-3241
Country	:	US
Telephone Number	:	718-217-0500
Fax Number	:	718-217-0533

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	URMILA SHIVARAM
Credential	:	M.D.
Telephone Number	:	718-217-0500

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	12/12/2014

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Directions to “UTOPIA HEARTCARE PLLC ” Practice Location

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