Provider Demographics
NPI:1245240514
Name:ZOOM HEART IMAGING MEDICAL, PC
Entity Type:Organization
Organization Name:ZOOM HEART IMAGING MEDICAL, PC
Other - Org Name:SAME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:
Authorized Official - First Name:ZAZA
Authorized Official - Middle Name:
Authorized Official - Last Name:AIVAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-804-8590
Mailing Address - Street 1:650 CENTRAL AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2301
Mailing Address - Country:US
Mailing Address - Phone:516-804-8590
Mailing Address - Fax:516-804-8591
Practice Address - Street 1:650 CENTRAL AVE
Practice Address - Street 2:SUTIE K
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2301
Practice Address - Country:US
Practice Address - Phone:516-804-8590
Practice Address - Fax:516-804-8591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWWP451Medicare PIN