Provider Demographics
NPI:1649585399
Name:NEW YORK HEART AND VASCULAR SPECIALISTS PC
Entity Type:Organization
Organization Name:NEW YORK HEART AND VASCULAR SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GOPI
Authorized Official - Middle Name:KRISHNA
Authorized Official - Last Name:PUNUKOLLU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-350-9344
Mailing Address - Street 1:3309 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2711
Mailing Address - Country:US
Mailing Address - Phone:347-350-9344
Mailing Address - Fax:718-693-4176
Practice Address - Street 1:3309 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2711
Practice Address - Country:US
Practice Address - Phone:347-350-9344
Practice Address - Fax:718-693-4176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244121207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty