Provider Demographics
NPI:1275395139
Name:AB CARDIOVASCULAR MEDICINE PC
Entity Type:Organization
Organization Name:AB CARDIOVASCULAR MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMGAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-907-2819
Mailing Address - Street 1:66 SUGAR MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3229
Mailing Address - Country:US
Mailing Address - Phone:917-907-2819
Mailing Address - Fax:781-523-2482
Practice Address - Street 1:8117 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2854
Practice Address - Country:US
Practice Address - Phone:718-360-0760
Practice Address - Fax:781-523-2482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty