Provider Demographics
NPI:1942326665
Name:HEARTLAND MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:HEARTLAND MEDICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-761-2800
Mailing Address - Street 1:PO BOX 141280
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1280
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:251 RICHMOND HILL RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5906
Practice Address - Country:US
Practice Address - Phone:718-761-2800
Practice Address - Fax:718-494-6829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226582207Q00000X
NY209836207Q00000X
NY136429207R00000X
NY234547207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2590572OtherAETNA HMO
NYW5A401OtherEMPIRE BCBS URGICARE
NY2590572OtherAETNA HMO