Personalized Cardiac Care PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PERSONALIZED CARDIAC CARE PC

Practice address

211 E 79TH St
New York, NY 10075-0819

Phone

(212) 879-1600

NPI assigned

May 6, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Zaza Josuhua Aivazi, MD

Title

MD

Phone

(718) 454-4356

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1194380105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 ADDISON ST",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115982937",
            "telephone_number": "718-440-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E 79TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750819",
            "telephone_number": "212-879-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED CARDIAC CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "AIVAZI",
        "authorized_official_first_name": "ZAZA",
        "authorized_official_middle_name": "JOSUHUA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-454-4356",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2491454",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.