Provider Demographics
NPI:1235155417
Name:GREENPOINT CARDIAC & MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:GREENPOINT CARDIAC & MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAREK
Authorized Official - Middle Name:
Authorized Official - Last Name:STAWIARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-389-6575
Mailing Address - Street 1:145 NASSAU AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-4004
Mailing Address - Country:US
Mailing Address - Phone:718-389-6575
Mailing Address - Fax:
Practice Address - Street 1:145 NASSAU AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-4004
Practice Address - Country:US
Practice Address - Phone:718-389-6575
Practice Address - Fax:718-389-4977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212145207R00000X
NY194855207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WDL031Medicare UPIN