Provider Demographics
NPI:1558899476
Name:CARDIOVASCULARTECHS INC.
Entity Type:Organization
Organization Name:CARDIOVASCULARTECHS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINIX
Authorized Official - Suffix:
Authorized Official - Credentials:RCS
Authorized Official - Phone:917-557-4844
Mailing Address - Street 1:4064 BRUNER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2229
Mailing Address - Country:US
Mailing Address - Phone:917-557-4844
Mailing Address - Fax:
Practice Address - Street 1:4064 BRUNER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2229
Practice Address - Country:US
Practice Address - Phone:917-557-4844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1144281973OtherNPI
NY1144281973Medicaid