Provider Demographics
NPI:1700855459
Name:CARDIOGRAPHIC ASSOCIATES OF HARLEM ROAD P.C.
Entity Type:Organization
Organization Name:CARDIOGRAPHIC ASSOCIATES OF HARLEM ROAD P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.P.A.
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-662-2161
Mailing Address - Street 1:P.O. BOX 8000 DEPT 819
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2605 HARLEM RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4018
Practice Address - Country:US
Practice Address - Phone:716-662-2161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
111311300OtherDEPARTMENT OF LABOR
NY000502751003OtherBLUE CROSS
NYCC0869OtherRAILROAD MEDICARE
027515Medicare ID - Type Unspecified