Provider Demographics
NPI:1689706871
Name:CARDIOLOGY CENTER OF NORTH JERSEY
Entity Type:Organization
Organization Name:CARDIOLOGY CENTER OF NORTH JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-778-3777
Mailing Address - Street 1:1030 CLIFTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013
Mailing Address - Country:US
Mailing Address - Phone:973-778-3777
Mailing Address - Fax:973-778-3252
Practice Address - Street 1:1030 CLIFTON AVENUE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:973-778-3777
Practice Address - Fax:973-778-3252
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIOLOGY CENTER OF NORTH JERSEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-12
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ405632Medicare PIN