Provider Demographics
NPI:1235300559
Name:CARDIOVASCULAR INTERVENTIONALISTS OF CENTRAL JERSEY, P.A.
Entity Type:Organization
Organization Name:CARDIOVASCULAR INTERVENTIONALISTS OF CENTRAL JERSEY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-613-1988
Mailing Address - Street 1:465 CRANBURY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-7600
Mailing Address - Country:US
Mailing Address - Phone:732-613-1988
Mailing Address - Fax:732-651-8747
Practice Address - Street 1:465 CRANBURY RD
Practice Address - Street 2:SUITE 201
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-7600
Practice Address - Country:US
Practice Address - Phone:732-613-1988
Practice Address - Fax:732-651-8747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
901212Medicare PIN