Provider Demographics
NPI:1871232710
Name:MANHATTAN INTEGRATIVE CARDIOVASCULAR
Entity Type:Organization
Organization Name:MANHATTAN INTEGRATIVE CARDIOVASCULAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-279-0688
Mailing Address - Street 1:405 GREENWICH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2047
Mailing Address - Country:US
Mailing Address - Phone:646-279-0688
Mailing Address - Fax:
Practice Address - Street 1:133 E 58TH ST STE 1402
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1236
Practice Address - Country:US
Practice Address - Phone:646-705-0035
Practice Address - Fax:877-409-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty