1821285107 NPI number — VILLAGE CARDIOLOGY PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821285107 NPI number — VILLAGE CARDIOLOGY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VILLAGE CARDIOLOGY 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's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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 Information

NPI Number:
1821285107
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30739 GENERAL POST OFFICE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10087-0739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-401-2046
Provider Business Mailing Address Fax Number:
610-401-2100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
154 W 14TH ST
Provider Second Line Business Practice Location Address:
4TH FL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10011-7307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-604-7880
Provider Business Practice Location Address Fax Number:
212-604-3389
Provider Enumeration Date:
10/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BRICK
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
212-604-7880

Provider Taxonomy Codes

  • Taxonomy code: 2080P0202X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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