Provider Demographics
NPI:1548417124
Name:SOMERSET MEDICAL CENTER
Entity Type:Organization
Organization Name:SOMERSET MEDICAL CENTER
Other - Org Name:SMC CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:PARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-685-2200
Mailing Address - Street 1:110 REHILL AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2519
Mailing Address - Country:US
Mailing Address - Phone:908-685-2200
Mailing Address - Fax:
Practice Address - Street 1:110 REHILL AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2519
Practice Address - Country:US
Practice Address - Phone:908-685-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4138422Medicaid
NJ528972OtherMEDICARE CARDIOLOGY