Provider Demographics
NPI:1316010085
Name:HMC CARDIAC DIAGNOSTIC SERVICE
Entity Type:Organization
Organization Name:HMC CARDIAC DIAGNOSTIC SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYANT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:551-996-2310
Mailing Address - Street 1:211 ESSEX ST
Mailing Address - Street 2:SUIT 104
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3231
Mailing Address - Country:US
Mailing Address - Phone:202-489-3888
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT AVE.
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-2310
Practice Address - Fax:201-996-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ527154Medicare ID - Type Unspecified