Provider Demographics
NPI:1538213335
Name:ROCKLAND CARDIOLOGY CARE P.C.
Entity type:Organization
Organization Name:ROCKLAND CARDIOLOGY CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ROOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-362-1500
Mailing Address - Street 1:972 ROUTE 45
Mailing Address - Street 2:SUITE 103
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3519
Mailing Address - Country:US
Mailing Address - Phone:845-362-1500
Mailing Address - Fax:845-362-1600
Practice Address - Street 1:972 ROUTE 45
Practice Address - Street 2:SUITE 103
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3519
Practice Address - Country:US
Practice Address - Phone:845-362-1500
Practice Address - Fax:845-362-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01583724Medicaid
NY01583724Medicaid
NYG12651Medicare UPIN
NY43J421Medicare ID - Type Unspecified