Provider Demographics
NPI:1841563657
Name:STATWIDE CARDIOVASCULAR.P.C
Entity Type:Organization
Organization Name:STATWIDE CARDIOVASCULAR.P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NALINIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KISTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-224-6969
Mailing Address - Street 1:5847 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE14
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1698
Mailing Address - Country:US
Mailing Address - Phone:718-224-6969
Mailing Address - Fax:
Practice Address - Street 1:5847 FRANCIS LEWIS BLVD
Practice Address - Street 2:SUITE14
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11364-1698
Practice Address - Country:US
Practice Address - Phone:718-224-6969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty