Provider Demographics
NPI:1336147859
Name:GRAMERCY CARDIAC DIAGNOSTIC SERVICES, P.C.
Entity Type:Organization
Organization Name:GRAMERCY CARDIAC DIAGNOSTIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRECERTIFICATION/CREDENTIALS
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-475-8066
Mailing Address - Street 1:131 W 35TH ST
Mailing Address - Street 2:FLOOR 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2111
Mailing Address - Country:US
Mailing Address - Phone:212-475-8066
Mailing Address - Fax:212-475-4175
Practice Address - Street 1:131 W 35TH ST
Practice Address - Street 2:FLOOR 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2111
Practice Address - Country:US
Practice Address - Phone:212-475-8066
Practice Address - Fax:212-475-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-144465-1207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7246OtherAFFINITY
NYNY00062OtherBEECHSTREET
NYWFL491OtherEMPIRE BCBS
NY00707915-011Medicaid
NY0607377 & 4547009OtherAETNA HMO & PPO
NY75979OtherMEDICARE
NY1701681OtherFIRSTHEALTH
NY0075979OtherGHI PPO
NY423458957OtherHEALTHPLUS
NYP2616990OtherOXFORD
NYW19161Medicare PIN