Basic Information
| Provider Information | |||||||||
| NPI: | 1194816348 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BARTEL R. CRISAFI, MD | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GREENWICH CARDIOLOGY ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35 RIVER RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | COS COB | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068072717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038695515 | ||||||||
| FaxNumber: | 2038695765 | ||||||||
| Practice Location | |||||||||
| Address1: | 35 RIVER RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | COS COB | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068072717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038695515 | ||||||||
| FaxNumber: | 2038695765 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 09/10/2007 | ||||||||
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| AuthorizedOfficialLastName: | CRISAFI | ||||||||
| AuthorizedOfficialFirstName: | BARTEL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2038695515 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 11889 | CT | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.