Provider Demographics
NPI:1306032826
Name:NORTHEAST HEART PC
Entity Type:Organization
Organization Name:NORTHEAST HEART PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SINACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-296-1256
Mailing Address - Street 1:2675 N DECATUR RD
Mailing Address - Street 2:200
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6131
Mailing Address - Country:US
Mailing Address - Phone:404-296-1256
Mailing Address - Fax:404-296-1850
Practice Address - Street 1:2675 N DECATUR RD
Practice Address - Street 2:200
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6131
Practice Address - Country:US
Practice Address - Phone:404-296-1256
Practice Address - Fax:404-296-1850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty