Provider Demographics
NPI:1649342049
Name:CHADI CARDIOLOGY
Entity type:Organization
Organization Name:CHADI CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-298-6739
Mailing Address - Street 1:16403 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4140
Mailing Address - Country:US
Mailing Address - Phone:718-298-6739
Mailing Address - Fax:718-298-6789
Practice Address - Street 1:16403 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4140
Practice Address - Country:US
Practice Address - Phone:718-298-6739
Practice Address - Fax:718-298-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185414246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01365535Medicaid
NY07037GMedicare ID - Type Unspecified
NY01365535Medicaid