Provider Demographics
NPI:1477545317
Name:CUMBERLAND CARDIOLOGY PA
Entity Type:Organization
Organization Name:CUMBERLAND CARDIOLOGY PA
Other - Org Name:CUMBERLAND CARDIOLOGY AND DIAGNOSTIC CENTER PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-691-6300
Mailing Address - Street 1:2848 S DELSEA DR
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7042
Mailing Address - Country:US
Mailing Address - Phone:856-691-6300
Mailing Address - Fax:856-691-0444
Practice Address - Street 1:2848 S DELSEA DR
Practice Address - Street 2:SUITE 4A
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7042
Practice Address - Country:US
Practice Address - Phone:856-691-6300
Practice Address - Fax:856-691-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04924400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1467603Medicaid
NJ1467603Medicaid
NJ544398Medicare ID - Type Unspecified