Provider Demographics
NPI:1902948201
Name:DR.VALERY KUZNETSOV CARDIOLOGIST P.C.
Entity Type:Organization
Organization Name:DR.VALERY KUZNETSOV CARDIOLOGIST P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUZNETSOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:171-621-1585
Mailing Address - Street 1:833 MOORE STREET
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598
Mailing Address - Country:US
Mailing Address - Phone:171-862-1158
Mailing Address - Fax:
Practice Address - Street 1:202 FOSTER AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230
Practice Address - Country:US
Practice Address - Phone:171-862-1158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207084207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty