Provider Demographics
NPI:1033136593
Name:MIDDLESEX CARDIAC DIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:MIDDLESEX CARDIAC DIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUDNITZKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-494-6300
Mailing Address - Street 1:98 JAMES STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:732-494-6300
Mailing Address - Fax:732-494-1028
Practice Address - Street 1:98 JAMES STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-494-6300
Practice Address - Fax:732-494-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA29856207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ696675Medicare PIN