Organization
CARDIAC COMMUNITY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAL N. KLESTZICK D.O. (SUPERVISOR)
(718) 239-5877
Entity
Organization
Contact information
Practice address
2475 SAINT RAYMONDS AVE, 4TH FLOOR, BRONX, NY 10461-3124
(718) 239-5877
(718) 239-6957
Mailing address
2475 SAINT RAYMONDS AVE, 4TH FLOOR, BRONX, NY 10461-3124
(718) 239-5877
(718) 239-6957
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
195483
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01971168
—
NY
Enumeration date
05/09/2007
Last updated
08/22/2020
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