Provider Demographics
NPI:1083696686
Name:STATEN ISLAND HEART P.C.
Entity Type:Organization
Organization Name:STATEN ISLAND HEART P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-663-7000
Mailing Address - Street 1:501 SEAVIEW AVE.
Mailing Address - Street 2:STE 300
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3436
Mailing Address - Country:US
Mailing Address - Phone:718-663-7000
Mailing Address - Fax:718-663-7090
Practice Address - Street 1:501 SEAVIEW AVE.
Practice Address - Street 2:STE 300
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3436
Practice Address - Country:US
Practice Address - Phone:718-663-7000
Practice Address - Fax:718-663-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty