Provider Demographics
NPI:1952464042
Name:CARDIOVASCULAR ASSOCIATES OF WESTCHESTER
Entity Type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES OF WESTCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:IRA
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-576-7171
Mailing Address - Street 1:140 LOCKWOOD AVENUE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4915
Mailing Address - Country:US
Mailing Address - Phone:914-576-7171
Mailing Address - Fax:914-840-1112
Practice Address - Street 1:140 LOCKWOOD AVENUE
Practice Address - Street 2:SUITE 310
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10901-4915
Practice Address - Country:US
Practice Address - Phone:914-576-7171
Practice Address - Fax:914-840-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135068207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2C4798OtherHEALTHNET
WS965OtherOXFORD
0079828OtherGHI
93A791OtherBLUE CROSS
0795550OtherCIGNA
93A791OtherBLUE CROSS
93A791OtherBLUE CROSS