Provider Demographics
NPI:1194912527
Name:BLACKSTONE CARDIOLOGY ASSOCIATES, PC
Entity type:Organization
Organization Name:BLACKSTONE CARDIOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:HORDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-723-1210
Mailing Address - Street 1:60 MESSENGER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2258
Mailing Address - Country:US
Mailing Address - Phone:401-723-1210
Mailing Address - Fax:401-312-2099
Practice Address - Street 1:333 SCHOOL ST
Practice Address - Street 2:SUITE 112
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5334
Practice Address - Country:US
Practice Address - Phone:401-723-1210
Practice Address - Fax:401-312-2099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21720Medicare PIN