Organization
CARDIOLOGY FOR LIFE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD R PERALTA HERNANDEZ MD (CARDIOLOGIST)
(646) 399-0201
Entity
Organization
Contact information
Practice address
25 S MAIN ST, SPRING VALLEY, NY 10977-4917
(646) 399-0201
Mailing address
25 S MAIN ST STE C, SPRING VALLEY, NY 10977-4917
(845) 694-3810
(845) 694-3812
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
667569375
DRIVER LICENSE #
NY
Enumeration date
03/29/2019
Last updated
06/11/2019
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