Provider Demographics
NPI:1376743831
Name:ASTORIA CARDIOLOGY GROUP,PC
Entity Type:Organization
Organization Name:ASTORIA CARDIOLOGY GROUP,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PALKHIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-204-7200
Mailing Address - Street 1:4207 30 AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2910
Mailing Address - Country:US
Mailing Address - Phone:718-240-7200
Mailing Address - Fax:718-267-0060
Practice Address - Street 1:4207 30 AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2910
Practice Address - Country:US
Practice Address - Phone:718-240-7200
Practice Address - Fax:718-267-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134301207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06405Medicare PIN