Provider Demographics
NPI:1467485623
Name:COMPREHENSIVE CARDIOVASCULAR CONSULTANTS PC
Entity Type:Organization
Organization Name:COMPREHENSIVE CARDIOVASCULAR CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAYEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMOON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-877-5160
Mailing Address - Street 1:22-36 RADBURN RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-4524
Mailing Address - Country:US
Mailing Address - Phone:973-877-5160
Mailing Address - Fax:973-877-5124
Practice Address - Street 1:268 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102
Practice Address - Country:US
Practice Address - Phone:973-877-5160
Practice Address - Fax:973-877-5124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMO55516207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty