Provider Demographics
NPI:1922010644
Name:CAPITAL REGION CARDIOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CAPITAL REGION CARDIOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IGAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZURAVICKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-438-6236
Mailing Address - Street 1:854 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3712
Mailing Address - Country:US
Mailing Address - Phone:518-438-6236
Mailing Address - Fax:518-438-6750
Practice Address - Street 1:854 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3712
Practice Address - Country:US
Practice Address - Phone:518-438-6236
Practice Address - Fax:518-438-6750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01265163Medicaid
NY1434OtherCDPHP GROUP ID
NYCAOW969410OtherEMPIRE BLUE CROSS GROUP
9814OtherGHI HMO GROUP ID
4496561OtherAETNA GROUP ID
0051124OtherGHI GROUP ID
4496561OtherAETNA GROUP ID
CB0113Medicare ID - Type UnspecifiedRAILROAD MEDICARE GROUP