Provider Demographics
NPI:1568468551
Name:ADVANCED CARDIAC SURGICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:ADVANCED CARDIAC SURGICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HRATCH
Authorized Official - Middle Name:L
Authorized Official - Last Name:KARAMANOUKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-839-3638
Mailing Address - Street 1:PO BOX 121
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14231-0121
Mailing Address - Country:US
Mailing Address - Phone:716-839-3638
Mailing Address - Fax:716-839-3102
Practice Address - Street 1:5225 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3573
Practice Address - Country:US
Practice Address - Phone:716-839-3638
Practice Address - Fax:716-839-3102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01918116Medicaid
NYAA0211Medicare UPIN