Provider Demographics
NPI:1134500762
Name:CARDIOLOGY DIAGNOSTIC ASSOCIATE
Entity Type:Organization
Organization Name:CARDIOLOGY DIAGNOSTIC ASSOCIATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:MILANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-543-3400
Mailing Address - Street 1:200 RIVERSIDE BLVD
Mailing Address - Street 2:APT 15D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10069-0901
Mailing Address - Country:US
Mailing Address - Phone:212-543-3400
Mailing Address - Fax:212-876-1960
Practice Address - Street 1:115 CENTRAL PARK W
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4198
Practice Address - Country:US
Practice Address - Phone:212-543-3400
Practice Address - Fax:212-873-1960
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIOLOGY DIAGNOSTIC ASSOCIATE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-09
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG82039Medicare UPIN