1437334646 NPI number — ADVANCED CARDIAC CARE,PLLC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437334646 NPI number — ADVANCED CARDIAC CARE,PLLC

Employer Identification Number (EIN):

Provider Organization Name:

ADVANCED CARDIAC CARE,PLLC

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

MICHAEL AVARICIO

Provider Other Organization Name Type Code:

5

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1437334646

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

10/04/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

9511 101ST AVE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

OZONE PARK

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

11416-2500

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

646-270-1967

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

9511 101ST AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

OZONE PARK

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

11416-2500

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

646-270-1967

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

01/07/2008

Authorized Official Last Name:

AVARICIO

Authorized Official First Name:

MICHAEL

Authorized Official Middle Name:

LUZ

Authorized Official Title or Position:

CARDIOLOGIST

Authorized Official Telephone Number:

718-360-5060

• Taxonomy code: 174400000X , with the licence number:  222928-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 2831485 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 463645P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 0231345 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
• Identifier: 0237948 . This is a "GHI PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 768AB1 . This is a "EMPIRE" identifier . This identifiers is of the category "OTHER".
• Identifier: 100283148501 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
• Identifier: 0529996 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 9174139 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 1754308 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 100283148501 . This is a "UNITED HEALTHCARE OF NY" identifier . This identifiers is of the category "OTHER".
• Identifier: 8168740 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: P3776399 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
• Identifier: 767AY1 . This is a "EMPIRE BLUE CROSS" identifier . This identifiers is of the category "OTHER".