Provider Demographics
NPI:1326390253
Name:NEW YORK CARDIOVASCULAR SURGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NEW YORK CARDIOVASCULAR SURGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANASTASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-931-9090
Mailing Address - Street 1:5 TUDOR CITY PL
Mailing Address - Street 2:APT 712
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6853
Mailing Address - Country:US
Mailing Address - Phone:212-889-1171
Mailing Address - Fax:212-889-1173
Practice Address - Street 1:210 PASSAIC ST
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-1355
Practice Address - Country:US
Practice Address - Phone:973-773-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08742300208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ249370Medicare PIN