Organization
GOLD COAST CARDIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CLANCY (EXECUTIVE ADMINISTRATOR)
(631) 983-3934
Entity
Organization
Contact information
Practice address
370 NORTHERN BLVD, GREAT NECK, NY 11021-4813
(516) 874-0441
(516) 874-0441
Mailing address
370 NORTHERN BLVD, GREAT NECK, NY 11021-4813
(516) 874-0441
(516) 874-0441
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
175571-1
NY
207UN0901X
Nuclear Cardiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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