Provider Demographics
NPI:1275569857
Name:CARDIOIMAGING DIAGNOSTICS
Entity Type:Organization
Organization Name:CARDIOIMAGING DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-926-6005
Mailing Address - Street 1:5 LYONS MALL
Mailing Address - Street 2:#308
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1928
Mailing Address - Country:US
Mailing Address - Phone:877-926-6005
Mailing Address - Fax:908-926-6005
Practice Address - Street 1:5 LYONS MALL
Practice Address - Street 2:#308
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1928
Practice Address - Country:US
Practice Address - Phone:877-926-6005
Practice Address - Fax:908-926-6005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ076958261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ076958Medicare ID - Type UnspecifiedIDTF # FOR NEW JERSEY
NY97Z841Medicare ID - Type UnspecifiedIDTF FOR NEW YORK