Provider Demographics
NPI:1740510478
Name:ASTORIA CARDIOVASCULAR SERVICES, PC
Entity type:Organization
Organization Name:ASTORIA CARDIOVASCULAR SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGIOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-932-2900
Mailing Address - Street 1:3503 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1434
Mailing Address - Country:US
Mailing Address - Phone:718-932-2900
Mailing Address - Fax:718-932-5115
Practice Address - Street 1:3503 31ST AVENUE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-1434
Practice Address - Country:US
Practice Address - Phone:718-932-2900
Practice Address - Fax:718-932-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166154174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty