Provider Demographics
NPI: | 1477037067 |
---|---|
Name: | BROOKLYN HEART VEIN AND VASCULAR CARE, PLLC |
Entity Type: | Organization |
Organization Name: | BROOKLYN HEART VEIN AND VASCULAR CARE, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | NAY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HTYTE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD, FACC |
Authorized Official - Phone: | 347-753-3244 |
Mailing Address - Street 1: | 147 PRINCE ST # 369 |
Mailing Address - Street 2: | |
Mailing Address - City: | BROOKLYN |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11201-3007 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-704-3032 |
Mailing Address - Fax: | 844-887-7251 |
Practice Address - Street 1: | 32 COURT ST STE 1703 |
Practice Address - Street 2: | |
Practice Address - City: | BROOKLYN |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11201-4404 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-704-3032 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-09-19 |
Last Update Date: | 2018-09-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Single Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty | |
No | 207RH0005X | Allopathic & Osteopathic Physicians | Internal Medicine | Hypertension Specialist | Group - Single Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Single Specialty |
No | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | Group - Single Specialty |
No | 246X00000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist Cardiovascular | Group - Single Specialty | |
No | 246XC2901X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist Cardiovascular | Cardiovascular Invasive Specialist | Group - Single Specialty |
No | 246XC2903X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist Cardiovascular | Vascular Specialist | Group - Single Specialty |
No | 246XS1301X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist Cardiovascular | Sonography | Group - Single Specialty |
No | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | Medical Specialty | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 03368334 | Medicaid |