Provider Demographics
NPI:1083894885
Name:ADVANCED CARDIOLOGY OF SOUTH JERSEY
Entity Type:Organization
Organization Name:ADVANCED CARDIOLOGY OF SOUTH JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO, FACC, FASE, RPVI
Authorized Official - Phone:856-241-3838
Mailing Address - Street 1:4 BURTON LN STE 100
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9441
Mailing Address - Country:US
Mailing Address - Phone:856-241-3838
Mailing Address - Fax:856-241-3849
Practice Address - Street 1:4 BURTON LN STE 100
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062
Practice Address - Country:US
Practice Address - Phone:856-241-3838
Practice Address - Fax:856-241-3849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0021458Medicaid
NJ100162Medicare PIN
NJ0021458Medicaid