Provider Demographics
NPI:1164571899
Name:CARDIO-KINETICS, INC.
Entity Type:Organization
Organization Name:CARDIO-KINETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:302-738-6635
Mailing Address - Street 1:52 N CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2267
Mailing Address - Country:US
Mailing Address - Phone:302-738-6635
Mailing Address - Fax:302-738-6637
Practice Address - Street 1:52 N CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-2267
Practice Address - Country:US
Practice Address - Phone:302-738-6635
Practice Address - Fax:302-738-6637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE198901874261QR0404X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE99093OtherCARDIAC REHABILITATION
DE99093OtherCARDIAC REHABILITATION
DE=========OtherCARDIAC REHABILITATION