Provider Demographics
NPI:1003830589
Name:DOWNTOWN NUCLEAR CARDIOLOGY, P.C.
Entity Type:Organization
Organization Name:DOWNTOWN NUCLEAR CARDIOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:TZALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-312-5000
Mailing Address - Street 1:170 WILLIAM ST
Mailing Address - Street 2:SUITE 814
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-2612
Mailing Address - Country:US
Mailing Address - Phone:212-312-5000
Mailing Address - Fax:212-312-5266
Practice Address - Street 1:170 WILLIAM ST
Practice Address - Street 2:SUITE 814
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2612
Practice Address - Country:US
Practice Address - Phone:212-312-5000
Practice Address - Fax:212-312-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131462207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01612486Medicaid
NYOW1U501Medicare ID - Type Unspecified