Provider Demographics
NPI:1134192941
Name:CARDIAC CARE ASSOCIATES PC
Entity type:Organization
Organization Name:CARDIAC CARE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:MILES
Authorized Official - Last Name:PARELES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-249-9175
Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:SUITE 805
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5501
Mailing Address - Country:US
Mailing Address - Phone:860-249-9175
Mailing Address - Fax:860-249-7866
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 805
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-249-9175
Practice Address - Fax:860-249-7866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC00080Medicare PIN