Provider Demographics
NPI:1104859172
Name:CARDIOLOGY ASSOCIATES OF FAIRFIELD COUNTY PC
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF FAIRFIELD COUNTY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-845-2160
Mailing Address - Street 1:1177 SUMMER STREET
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5572
Mailing Address - Country:US
Mailing Address - Phone:203-353-1133
Mailing Address - Fax:203-353-1133
Practice Address - Street 1:1177 SUMMER STREET
Practice Address - Street 2:5TH FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5572
Practice Address - Country:US
Practice Address - Phone:203-353-1133
Practice Address - Fax:203-323-1133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT207RC0000X
207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C00598Medicare UPIN