Basic Information
| Provider Information | |||||||||
| NPI: | 1225235518 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. FRANCIS CARDIAC PREVENTION, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1034 | ||||||||
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| City: | PORT WASHINGTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110501034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166292484 | ||||||||
| FaxNumber: | 5166292027 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 NORTHERN BLVD | ||||||||
| Address2: | |||||||||
| City: | GREENVALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115481203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166292484 | ||||||||
| FaxNumber: | 5166292027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 11/14/2008 | ||||||||
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| AuthorizedOfficialLastName: | GUERCI | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5166292081 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.