Provider Demographics
NPI:1528349099
Name:CARDIOVASCULAR PREVENTION AND THERAPEUTICS OF NY, PLLC
Entity type:Organization
Organization Name:CARDIOVASCULAR PREVENTION AND THERAPEUTICS OF NY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-755-8700
Mailing Address - Street 1:133 E 58TH ST
Mailing Address - Street 2:SUITE 301/304
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1236
Mailing Address - Country:US
Mailing Address - Phone:212-755-8700
Mailing Address - Fax:212-755-5342
Practice Address - Street 1:133 E 58TH ST
Practice Address - Street 2:SUITE 301/304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1236
Practice Address - Country:US
Practice Address - Phone:212-755-8700
Practice Address - Fax:212-755-5342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150380207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty