Provider Demographics
NPI:1689088742
Name:CARDIOVASCULAR AND MEDICAL ASSOCIATE OF THE HUDSON VALLEY PC
Entity Type:Organization
Organization Name:CARDIOVASCULAR AND MEDICAL ASSOCIATE OF THE HUDSON VALLEY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOTONELLY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD/JD, FACC, FSCAI
Authorized Official - Phone:845-831-0471
Mailing Address - Street 1:12 ROLLING RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:845-831-0471
Mailing Address - Fax:845-831-0306
Practice Address - Street 1:841 ROUTE 52 SUITE 6
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524
Practice Address - Country:US
Practice Address - Phone:845-831-0471
Practice Address - Fax:845-831-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1401941207RC0000X
NY140194207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty