Provider Demographics
NPI:1053588657
Name:GRAMERCY CARDIAC DIAGNOSTIC SERVICES, P.C.
Entity type:Organization
Organization Name:GRAMERCY CARDIAC DIAGNOSTIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
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 1:920 BROADWAY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6004
Mailing Address - Country:US
Mailing Address - Phone:212-475-8066
Mailing Address - Fax:212-475-4175
Practice Address - Street 1:3706 82ND ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7017
Practice Address - Country:US
Practice Address - Phone:718-205-8066
Practice Address - Fax:718-205-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-144465207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty