Provider Demographics
NPI:1114202124
Name:CARDIAC CARE CONSULTANTS
Entity Type:Organization
Organization Name:CARDIAC CARE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:NICCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-815-2484
Mailing Address - Street 1:13634 N 93RD AVE
Mailing Address - Street 2:300
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4914
Mailing Address - Country:US
Mailing Address - Phone:623-815-2484
Mailing Address - Fax:623-815-2483
Practice Address - Street 1:14420 W MEEKER BLVD
Practice Address - Street 2:103
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5286
Practice Address - Country:US
Practice Address - Phone:623-546-6700
Practice Address - Fax:623-546-0740
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIAC CARE CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-21
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty