Provider Demographics
NPI:1568039774
Name:TORELI CARDIOLOGY AND MEDICAL ASSOCIATES OF BROOKLYN, P.L.L.C.
Entity Type:Organization
Organization Name:TORELI CARDIOLOGY AND MEDICAL ASSOCIATES OF BROOKLYN, P.L.L.C.
Other - Org Name:SOUTH BROOKLYN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEKSANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:TORELI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-244-6608
Mailing Address - Street 1:716 AVENUE Y
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6127
Mailing Address - Country:US
Mailing Address - Phone:347-244-6608
Mailing Address - Fax:
Practice Address - Street 1:716 AVENUE Y
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6127
Practice Address - Country:US
Practice Address - Phone:347-244-6608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04831572Medicaid