Provider Demographics
NPI:1659412427
Name:HEART MEDICAL, PLLC
Entity Type:Organization
Organization Name:HEART MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-336-4806
Mailing Address - Street 1:1833 E 13TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2894
Mailing Address - Country:US
Mailing Address - Phone:718-336-4806
Mailing Address - Fax:718-336-4308
Practice Address - Street 1:145 E 15TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3531
Practice Address - Country:US
Practice Address - Phone:718-336-4806
Practice Address - Fax:718-336-4308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215539207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCW221Medicare ID - Type UnspecifiedEMPIRE MEDICARE