Provider Demographics
NPI:1609057959
Name:SUFFERN CARDIOLOGY, PC
Entity Type:Organization
Organization Name:SUFFERN CARDIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:CHIH
Authorized Official - Last Name:SHIH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-357-1717
Mailing Address - Street 1:79 ROUTE 59
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4913
Mailing Address - Country:US
Mailing Address - Phone:845-357-1717
Mailing Address - Fax:845-357-4819
Practice Address - Street 1:79 ROUTE 59
Practice Address - Street 2:SUITE 5
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4913
Practice Address - Country:US
Practice Address - Phone:845-357-1717
Practice Address - Fax:845-357-4819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY64165174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY37H241Medicare PIN