Organization
NORTHERN KENTUCKY HEART PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK GERAK (CHIEF OPERATION OFFICER)
(859) 341-3015
Entity
Organization
Contact information
Practice address
380 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3476
(859) 341-3015
(859) 341-3215
Mailing address
380 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3476
(859) 341-3015
(859) 341-3215
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65939522
—
KY
05
—
78903259
—
KY
Enumeration date
08/26/2005
Last updated
10/07/2010
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