Provider Demographics
NPI:1326194176
Name:BRONXVILLE CARDIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:BRONXVILLE CARDIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:MATILDA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:TADDEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-793-1606
Mailing Address - Street 1:1 PONDFIELD RD W
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-2666
Mailing Address - Country:US
Mailing Address - Phone:914-793-1606
Mailing Address - Fax:914-793-1837
Practice Address - Street 1:1 PONDFIELD RD W
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-2666
Practice Address - Country:US
Practice Address - Phone:914-793-1606
Practice Address - Fax:914-793-1837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168065207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW91101Medicare ID - Type Unspecified