Provider Demographics
NPI:1053629063
Name:MONROE CARDIOLOGY
Entity Type:Organization
Organization Name:MONROE CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:TANNENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-395-7600
Mailing Address - Street 1:18 CENTRE DRIVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1501
Mailing Address - Country:US
Mailing Address - Phone:609-395-7600
Mailing Address - Fax:609-395-7559
Practice Address - Street 1:18 CENTRE DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-1501
Practice Address - Country:US
Practice Address - Phone:609-395-7600
Practice Address - Fax:609-395-7559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04897700207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty