Astudillo, Luis Mario
Astudillo, Luis Mario is an sole proprietor health care provider with primary practice located at 3131 Grand Concourse Suite 1B, Bronx NY 10468-1442. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Astudillo, Luis Mario can be contacted via phone (718) 295-7900.Contact Information
Primary practice address
3131 Grand Concourse Suite 1B
Bronx NY 10468-1442
Phone: (718) 295-7900
Fax: (718) 295-4160
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 243249 | New York |
Profile Details
| NPI number | 1114974623 |
|---|---|
| LBN Legal business name | Astudillo, Luis Mario |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 28th, 2006 |
| Last updated | Mar 4th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114974623 | NPPES |
| Georgia | MEDICAID | 350518195A |
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