Provider Demographics
NPI:1043291248
Name:COMMUNITY CARDIOLOGY,PC
Entity Type:Organization
Organization Name:COMMUNITY CARDIOLOGY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-627-6622
Mailing Address - Street 1:800 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3821
Mailing Address - Country:US
Mailing Address - Phone:516-627-6622
Mailing Address - Fax:516-627-7845
Practice Address - Street 1:800 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3821
Practice Address - Country:US
Practice Address - Phone:516-627-6622
Practice Address - Fax:516-627-7845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW18961Medicare ID - Type Unspecified
NYB78821Medicare UPIN
NYF59110Medicare UPIN
NYA61245Medicare UPIN
NYC09553Medicare UPIN