Provider Demographics
NPI:1104355965
Name:US CARDIO JEFFERSON LLC
Entity Type:Organization
Organization Name:US CARDIO JEFFERSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-217-2480
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-0384
Mailing Address - Country:US
Mailing Address - Phone:845-217-2480
Mailing Address - Fax:845-217-2481
Practice Address - Street 1:6637 STATE ROUTE 30
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3171
Practice Address - Country:US
Practice Address - Phone:724-852-1444
Practice Address - Fax:724-522-5681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier