Organization
S J H CARDIAC CATHETERIZATION ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI AL-MUDAMGHA MD (PRESIDENT)
(315) 234-0906
Entity
Organization
Contact information
Practice address
4820 W TAFT RD, SUITE 209, LIVERPOOL, NY 13088-2800
(315) 448-6215
(315) 234-4416
Mailing address
4820 W TAFT RD, SUITE 209, LIVERPOOL, NY 13088-2800
(315) 448-6215
(315) 234-4416
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02130050
—
NY
Enumeration date
09/21/2005
Last updated
03/15/2012
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