Provider Demographics
NPI:1558353953
Name:ADIRONDACK CARDIOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:ADIRONDACK CARDIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINES OFFICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERZEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-792-1233
Mailing Address - Street 1:6 HEARTS WAY
Mailing Address - Street 2:PO BOX 4860
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804
Mailing Address - Country:US
Mailing Address - Phone:518-792-1233
Mailing Address - Fax:518-792-6854
Practice Address - Street 1:6 HEARTS WAY
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804
Practice Address - Country:US
Practice Address - Phone:518-792-1233
Practice Address - Fax:518-792-6854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY31627AMedicare PIN