Provider Demographics
NPI:1649339011
Name:COMPREHENSIVE CARDIAC CARE
Entity type:Organization
Organization Name:COMPREHENSIVE CARDIAC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTO
Authorized Official - Suffix:
Authorized Official - Credentials:RN,CPC
Authorized Official - Phone:845-279-3900
Mailing Address - Street 1:670 STONELEIGH AVE
Mailing Address - Street 2:STE 111
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3997
Mailing Address - Country:US
Mailing Address - Phone:845-279-3900
Mailing Address - Fax:845-279-4301
Practice Address - Street 1:670 STONELEIGH AVE
Practice Address - Street 2:STE 111
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3997
Practice Address - Country:US
Practice Address - Phone:845-279-3900
Practice Address - Fax:845-279-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW2L281Medicare ID - Type UnspecifiedMEDICARE GROUP ID