Provider Demographics
NPI:1437334646
Name:ADVANCED CARDIAC CARE,PLLC
Entity Type:Organization
Organization Name:ADVANCED CARDIAC CARE,PLLC
Other - Org Name:MICHAEL AVARICIO
Other - Org Type:Other Name
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LUZ
Authorized Official - Last Name:AVARICIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-360-5060
Mailing Address - Street 1:9511 101ST AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-2500
Mailing Address - Country:US
Mailing Address - Phone:646-270-1967
Mailing Address - Fax:
Practice Address - Street 1:9511 101ST AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-2500
Practice Address - Country:US
Practice Address - Phone:646-270-1967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222928-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2831485OtherUNITED HEALTHCARE
NY463645POtherHIP
0231345OtherGHI
0237948OtherGHI PPO
768AB1OtherEMPIRE
100283148501OtherAMERIGROUP
0529996OtherAETNA HMO
9174139OtherAETNA
1754308OtherAETNA HMO
100283148501OtherUNITED HEALTHCARE OF NY
8168740OtherCIGNA
P3776399OtherOXFORD
767AY1OtherEMPIRE BLUE CROSS
767AY1OtherEMPIRE BLUE CROSS