Provider Demographics
NPI:1366761579
Name:NEW YORK CARDIOVASCULAR PREVENTION LLC
Entity type:Organization
Organization Name:NEW YORK CARDIOVASCULAR PREVENTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:ARDEN
Authorized Official - Last Name:RADWANER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-717-0666
Mailing Address - Street 1:885 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0325
Mailing Address - Country:US
Mailing Address - Phone:212-717-0666
Mailing Address - Fax:212-988-6653
Practice Address - Street 1:885 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0325
Practice Address - Country:US
Practice Address - Phone:212-717-0666
Practice Address - Fax:212-717-0666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150577174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty