Provider Demographics
NPI:1174674808
Name:NORTH NASSAU CARDIOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:NORTH NASSAU CARDIOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-484-7893
Mailing Address - Street 1:70 GLEN STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2854
Mailing Address - Country:US
Mailing Address - Phone:516-484-7893
Mailing Address - Fax:
Practice Address - Street 1:70 GLEN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2854
Practice Address - Country:US
Practice Address - Phone:516-484-7893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW23561Medicare PIN