Provider Demographics
NPI:1366905523
Name:PREMIER CARDIAC AND VASCULAR LLC
Entity type:Organization
Organization Name:PREMIER CARDIAC AND VASCULAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-620-2718
Mailing Address - Street 1:406 CHATHAM SQUARE OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2585
Mailing Address - Country:US
Mailing Address - Phone:540-666-6181
Mailing Address - Fax:571-318-9438
Practice Address - Street 1:406 CHATHAM SQUARE OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2585
Practice Address - Country:US
Practice Address - Phone:540-666-6181
Practice Address - Fax:571-318-9438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty