Provider Demographics
NPI:1457698839
Name:CARDIOLOGY TECHNOLOGY GROUP INC
Entity Type:Organization
Organization Name:CARDIOLOGY TECHNOLOGY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGY TECHNICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRIMILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DORMOI
Authorized Official - Suffix:
Authorized Official - Credentials:NCET
Authorized Official - Phone:267-602-4734
Mailing Address - Street 1:1111 NAPFLE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-2742
Mailing Address - Country:US
Mailing Address - Phone:215-904-5922
Mailing Address - Fax:
Practice Address - Street 1:1111 NAPFLE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2742
Practice Address - Country:US
Practice Address - Phone:215-904-5922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA766381246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty