Provider Demographics
NPI:1053334276
Name:HUNTERDON CARDIOVASCULAR ASSOCIATES
Entity Type:Organization
Organization Name:HUNTERDON CARDIOVASCULAR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:ERIK
Authorized Official - Last Name:TONNESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-788-6471
Mailing Address - Street 1:1100 WESCOTT DRIVE
Mailing Address - Street 2:SUITE G-3
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822
Mailing Address - Country:US
Mailing Address - Phone:908-788-6471
Mailing Address - Fax:908-788-6460
Practice Address - Street 1:1100 WESCOTT DRIVE
Practice Address - Street 2:SUITE G-3
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:908-788-6471
Practice Address - Fax:908-788-6460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA063503Medicare PIN