Organization
PERSONALIZED CARDIAC CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZAZA JOSUHUA AIVAZI MD (MD)
(718) 454-4356
Entity
Organization
Contact information
Practice address
211 E 79TH ST, NEW YORK, NY 10075-0819
(212) 879-1600
Mailing address
777 ADDISON ST, WOODMERE, NY 11598-2937
(718) 440-6161
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2491454
—
NY
Enumeration date
05/06/2019
Last updated
05/06/2019
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