Provider Demographics
NPI:1194762989
Name:TRUESDALE CARDIOLOGY ASSOC INC
Entity type:Organization
Organization Name:TRUESDALE CARDIOLOGY ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHACHNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-676-3411
Mailing Address - Street 1:1030 PRESIDENT AVE
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5923
Mailing Address - Country:US
Mailing Address - Phone:508-676-3411
Mailing Address - Fax:508-674-7378
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-676-3411
Practice Address - Fax:508-674-7378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000022171OtherBMC HEALTHNET PLAN
MAC30182OtherRAILROAD MEDICARE
RI46361OtherRI BLUE SHIELD
MA25531OtherAETNA US HEALTH CARE
MA9753168Medicaid
RITC07057OtherEDS
MA0007992OtherNEIGHBORHOOD HEALTH
MAC465OtherHARVARD PILGRIM
MAM14484OtherBLUE SHIELD
MA612067OtherTUFTS HEALTH PLAN
MA9753168Medicaid