Provider Demographics
NPI:1639193287
Name:ISLAND HEART ASSOCIATES, LLP
Entity Type:Organization
Organization Name:ISLAND HEART ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-665-6393
Mailing Address - Street 1:19 E MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8330
Mailing Address - Country:US
Mailing Address - Phone:631-665-6393
Mailing Address - Fax:631-665-5870
Practice Address - Street 1:19 E MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8330
Practice Address - Country:US
Practice Address - Phone:631-665-6393
Practice Address - Fax:631-665-5870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEY341Medicare PIN