Provider Demographics
NPI:1831429760
Name:GRAMERCY CARDIOVASCULAR RADIOLOGY, PLLC
Entity type:Organization
Organization Name:GRAMERCY CARDIOVASCULAR RADIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LABARBERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-475-8066
Mailing Address - Street 1:PO BOX 9467
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11555-9467
Mailing Address - Country:US
Mailing Address - Phone:212-475-8066
Mailing Address - Fax:212-475-8487
Practice Address - Street 1:920 BROADWAY
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6004
Practice Address - Country:US
Practice Address - Phone:212-475-8066
Practice Address - Fax:212-475-8487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1444652085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty