Provider Demographics
NPI:1689630519
Name:CARDIO-SONIC OF CHERRY HILL, INC.
Entity Type:Organization
Organization Name:CARDIO-SONIC OF CHERRY HILL, INC.
Other - Org Name:CARDIOSONICS OF CHERRY HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERENATO
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:856-427-6528
Mailing Address - Street 1:8 BAYBERRY CT
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3945
Mailing Address - Country:US
Mailing Address - Phone:856-427-6528
Mailing Address - Fax:856-427-6528
Practice Address - Street 1:8 BAYBERRY CT
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3945
Practice Address - Country:US
Practice Address - Phone:856-427-6528
Practice Address - Fax:856-427-6528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ470000398OtherRAILROAD MEDICARE
NJ470000398OtherRAILROAD MEDICARE
NJ021486Medicare ID - Type UnspecifiedIDTF