Provider Demographics
NPI:1588613855
Name:RICHMOND CARDIO PULMONARY CARE PC
Entity Type:Organization
Organization Name:RICHMOND CARDIO PULMONARY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLOOMFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-720-1222
Mailing Address - Street 1:355 BARD AVE
Mailing Address - Street 2:VILLA BLDG 1ST FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310
Mailing Address - Country:US
Mailing Address - Phone:718-720-1222
Mailing Address - Fax:718-818-9909
Practice Address - Street 1:355 BARD AVE
Practice Address - Street 2:VILLA BLDG 1ST FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310
Practice Address - Country:US
Practice Address - Phone:718-720-1222
Practice Address - Fax:718-818-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-06
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW5Y041Medicare PIN