Provider Demographics
NPI:1609373778
Name:OCEAN AVE MEDICAL AND CARDIOREHAB P.C.
Entity type:Organization
Organization Name:OCEAN AVE MEDICAL AND CARDIOREHAB P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILVARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-527-6529
Mailing Address - Street 1:510 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1208
Mailing Address - Country:US
Mailing Address - Phone:516-399-2225
Mailing Address - Fax:516-399-2227
Practice Address - Street 1:510 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1208
Practice Address - Country:US
Practice Address - Phone:516-399-2225
Practice Address - Fax:516-399-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122512207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1003887852OtherNPI