Provider Demographics
NPI:1598936098
Name:HEIGHTS PHYSICIAN MEDICAL CARE P.C
Entity Type:Organization
Organization Name:HEIGHTS PHYSICIAN MEDICAL CARE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DILIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASTANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-927-5200
Mailing Address - Street 1:7 CECELIA AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2705
Mailing Address - Country:US
Mailing Address - Phone:201-943-3938
Mailing Address - Fax:201-941-5319
Practice Address - Street 1:616 W 184TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3908
Practice Address - Country:US
Practice Address - Phone:212-927-5200
Practice Address - Fax:212-568-2765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129598261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01731855Medicaid