Provider Demographics
NPI:1740209907
Name:CARDIOLOGY CONSULTANTS OF ROCKLAND, PC
Entity Type:Organization
Organization Name:CARDIOLOGY CONSULTANTS OF ROCKLAND, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PERMINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-942-1001
Mailing Address - Street 1:12 LIBERTY SQUARE MALL
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-2400
Mailing Address - Country:US
Mailing Address - Phone:845-942-1001
Mailing Address - Fax:845-942-1431
Practice Address - Street 1:12 LIBERTY SQUARE MALL
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-2400
Practice Address - Country:US
Practice Address - Phone:845-942-1001
Practice Address - Fax:845-942-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4588961OtherAETNA PPO GROUP
NY0976023OtherAETNA HMO GROUP
NYDB5612OtherRAILROAD MEDICARE GROUP
NYDB5612OtherRAILROAD MEDICARE GROUP
NYWES111Medicare PIN
NJ094743Medicare PIN