Provider Demographics
NPI:1003180738
Name:NEW YORK HEART AND VASCULAR SPECIALISTS PC
Entity Type:Organization
Organization Name:NEW YORK HEART AND VASCULAR SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GOPI
Authorized Official - Middle Name:K
Authorized Official - Last Name:PUNUKOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-425-1789
Mailing Address - Street 1:3309 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2711
Mailing Address - Country:US
Mailing Address - Phone:347-425-1789
Mailing Address - Fax:347-240-4434
Practice Address - Street 1:3309 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2711
Practice Address - Country:US
Practice Address - Phone:347-425-1789
Practice Address - Fax:347-240-4434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty