Provider Demographics
NPI:1578650636
Name:CARDIOVASCULAR CONSULTING GROUP
Entity Type:Organization
Organization Name:CARDIOVASCULAR CONSULTING GROUP
Other - Org Name:CARDIOVASCULAR IMAGING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FARBER
Authorized Official - Suffix:
Authorized Official - Credentials:JD, MBA
Authorized Official - Phone:888-637-2267
Mailing Address - Street 1:75 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1367
Mailing Address - Country:US
Mailing Address - Phone:888-637-2267
Mailing Address - Fax:888-637-2267
Practice Address - Street 1:75 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1367
Practice Address - Country:US
Practice Address - Phone:888-637-2267
Practice Address - Fax:888-637-2267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
Not Answered261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile