Provider Demographics
NPI:1376023689
Name:STAR CARDIOLOGY CARE PC
Entity Type:Organization
Organization Name:STAR CARDIOLOGY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DUBRAVKA
Authorized Official - Middle Name:I
Authorized Official - Last Name:STARCEVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-923-4499
Mailing Address - Street 1:403 ROUTE 202 STE 200
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-6037
Mailing Address - Country:US
Mailing Address - Phone:908-923-4499
Mailing Address - Fax:908-923-4011
Practice Address - Street 1:403 ROUTE 202 STE 200
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-6037
Practice Address - Country:US
Practice Address - Phone:908-923-4499
Practice Address - Fax:908-923-4011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07274800207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ860H509Medicaid