Basic Information
| Provider Information | |||||||||
| NPI: | 1134406374 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARDIAC ELECTROPHYSIOLOGY CONSULTANTS LLC | ||||||||
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| OtherOrganizationName: | HEART GROUP OF SYRACUSE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2003 | ||||||||
| Address2: | |||||||||
| City: | EAST SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130574503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154463904 | ||||||||
| FaxNumber: | 3155526590 | ||||||||
| Practice Location | |||||||||
| Address1: | 716 JAMES ST | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152772707 | ||||||||
| FaxNumber: | 3155051665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2011 | ||||||||
| LastUpdateDate: | 06/25/2018 | ||||||||
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| AuthorizedOfficialLastName: | AHMED | ||||||||
| AuthorizedOfficialFirstName: | JAMAL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 3152772707 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
No ID Information.