Provider Demographics
NPI:1073741229
Name:VUKELIC, SASA (MD)
Entity Type:Individual
Prefix:DR
First Name:SASA
Middle Name:
Last Name:VUKELIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 BAINBRIDGE AVENUE
Mailing Address - Street 2:MAP BUILDING 7TH FLOOR ADVANCED HEART FAILURE AND TRANS
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-920-2626
Mailing Address - Fax:
Practice Address - Street 1:3400 BAINBRIDGE AVENUE
Practice Address - Street 2:MAP BUILDING 7TH FLOOR ADVANCED HEART FAILURE AND TRANS
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA68862207R00000X
NY284601207RA0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology