Provider Demographics
NPI:1912298563
Name:PATCHOGUE CARDIOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:PATCHOGUE CARDIOLOGY ASSOCIATES PC
Other - Org Name:LONG ISLAND CARDIOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:SEMERTZIDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-447-8300
Mailing Address - Street 1:285 SILLS RD
Mailing Address - Street 2:BUILDING 14
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4869
Mailing Address - Country:US
Mailing Address - Phone:631-447-8300
Mailing Address - Fax:631-447-8872
Practice Address - Street 1:285 SILLS RD
Practice Address - Street 2:BUILDING 14
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4869
Practice Address - Country:US
Practice Address - Phone:631-447-8300
Practice Address - Fax:631-447-8872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty