Provider Demographics
NPI:1518026400
Name:WINTHROP CARDIOVASCULAR & THORACIC SURGERY, PC
Entity Type:Organization
Organization Name:WINTHROP CARDIOVASCULAR & THORACIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-663-4400
Mailing Address - Street 1:120 MINEOLA BLVD., SUITE 300
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-663-4400
Mailing Address - Fax:516-663-4404
Practice Address - Street 1:120 MINEOLA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4077
Practice Address - Country:US
Practice Address - Phone:516-663-4400
Practice Address - Fax:516-663-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1065802086S0129X, 208G00000X
NY1943402086S0129X
NY185586208G00000X
NY124484208G00000X
NY190141208G00000X
NY201051208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW1OW231410Medicare ID - Type UnspecifiedMEDICARE GROUP #