Provider Demographics
NPI:1083783559
Name:VALLEY CARDIOVASCULAR ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:VALLEY CARDIOVASCULAR ASSOCIATES, P.C.
Other - Org Name:ANDREW M GOLDMANN MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:GOLDMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-703-3000
Mailing Address - Street 1:75 CRYSTAL RUN ROAD
Mailing Address - Street 2:ORANGE REGIONAL MEDICAL PAVILION SUITE 100
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941
Mailing Address - Country:US
Mailing Address - Phone:845-703-3000
Mailing Address - Fax:845-703-3003
Practice Address - Street 1:75 CRYSTAL RUN ROAD
Practice Address - Street 2:ORANGE REGIONAL MEDICAL PAVILION SUITE 100
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941
Practice Address - Country:US
Practice Address - Phone:845-703-3000
Practice Address - Fax:845-703-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1312971207RC0000X
NJMA45975207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00827078Medicaid
958492OtherMVP
0035104OtherGHI PPO
111457OtherAETNA
NJ559415OtherMEDICARE
P471437OtherOXFORD
0034324OtherGHI HMO
P471437OtherOXFORD
B18764Medicare UPIN