| Interboro Heart & Vascular Pllc | |
|
12508 Liberty Ave South Richmond Hill NY 11419-2234 | |
| (718) 581-8093 | |
| Not Available |
| Full Name | Interboro Heart & Vascular Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12508 Liberty Ave, South Richmond Hill, New York |
| Authorized Official Name and Position | Srinivas Kesanakurthy (PRESIDENT) |
| Authorized Official Contact | 7185818093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Interboro Heart & Vascular Pllc 12508 Liberty Ave South Richmond Hill NY 11419-2234 Ph: (718) 581-8093 | Interboro Heart & Vascular Pllc 12508 Liberty Ave South Richmond Hill NY 11419-2234 Ph: (718) 581-8093 |
| NPI Number | 1609381458 |
|---|---|
| Provider Enumeration Date | 12/01/2017 |
| Last Update Date | 11/13/2023 |
| Medicare PECOS PAC ID | 7810258555 |
|---|---|
| Medicare Enrollment ID | O20180221000852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609381458 | NPI | - | NPPES |
| 1770558397 | Other | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
| Provider Name | Srinivas Kesanakurthy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770558397 PECOS PAC ID: 5890714356 Enrollment ID: I20051115000223 |
| Provider Name | Samir Garyali |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1679704605 PECOS PAC ID: 3072745751 Enrollment ID: I20140714001862 |
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