Provider Demographics
NPI:1518102854
Name:QUALITY HEART CARE
Entity Type:Organization
Organization Name:QUALITY HEART CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALCHANDANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-255-3617
Mailing Address - Street 1:7 VON HAGEN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2126
Mailing Address - Country:US
Mailing Address - Phone:631-255-3617
Mailing Address - Fax:
Practice Address - Street 1:116 TERRYVILLE RD
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-1329
Practice Address - Country:US
Practice Address - Phone:631-255-3617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217988207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty