Provider Demographics
NPI:1811019151
Name:RONALD GULOTTA, MD, PC
Entity Type:Organization
Organization Name:RONALD GULOTTA, MD, PC
Other - Org Name:ROSLYN HEIGHTS CARDIAC IMAGING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GULOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-365-5599
Mailing Address - Street 1:1 EXPRESSWAY PLZ
Mailing Address - Street 2:STE 201
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2047
Mailing Address - Country:US
Mailing Address - Phone:516-365-5599
Mailing Address - Fax:
Practice Address - Street 1:1 EXPRESSWAY PLZ
Practice Address - Street 2:STE 201
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2047
Practice Address - Country:US
Practice Address - Phone:516-365-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W35641Medicare ID - Type Unspecified