Provider Demographics
NPI:1679558654
Name:VAZZANA&BOGIN CARDIOLOGY ASSOC
Entity type:Organization
Organization Name:VAZZANA&BOGIN CARDIOLOGY ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:VAZZANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-663-6400
Mailing Address - Street 1:501 SEAVIEW AVE
Mailing Address - Street 2:SUITE200
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3436
Mailing Address - Country:US
Mailing Address - Phone:718-663-6400
Mailing Address - Fax:718-663-6490
Practice Address - Street 1:501 SEAVIEW AVE
Practice Address - Street 2:SUITE200
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3436
Practice Address - Country:US
Practice Address - Phone:718-663-6400
Practice Address - Fax:718-663-6490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD2415OtherMEDICARE RAILROAD
NY02602142Medicaid
NY02602142Medicaid