SHORE ROAD CARDIOLOGY ASSOCIATES PC NPI 1790791457

NPI Information

NPI: 1790791457
Provider Name: SHORE ROAD CARDIOLOGY ASSOCIATES, PC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
150 55TH ST
BROOKLYN, NY
ZIP 11220
Phone: (718) 630-7477
Get Directions

SHORE ROAD CARDIOLOGY ASSOCIATES, PC is a cardiovascular disease internal medicine in Brooklyn, NY. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. SHORE ROAD CARDIOLOGY ASSOCIATES, PC NPI is 1790791457. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

150 55TH ST
BROOKLYN, NY
ZIP 11220-559
Phone: (718) 630-7477
Fax: (718) 630-8515

The provider's authorized official is Gary Dellacerra .
The authorized official title is Vp Managed Care & Revenue Complianc and has the following contact phone number (718) 630-7103.

The enumeration date for this NPI number is 8/1/2006 and was last updated on 9/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0001X	Internal Medicine	Clinical Cardiac Electrophysiology	16885	NEW YORK	No
2	207RI0011X	Internal Medicine	Interventional Cardiology	16885	NEW YORK	No
3	207RC0000X	Internal Medicine	Cardiovascular Disease	16885	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00820939	MEDICAID	NEW YORK
2	W08931	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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