Provider Demographics
NPI:1700010741
Name:CARDIOVASCULAR IMAGING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR IMAGING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOVASCULAR TECHNOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-331-3400
Mailing Address - Street 1:763 CONVERY BLVD
Mailing Address - Street 2:ROUTE 35 SOUTH SUITE L1
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-2525
Mailing Address - Country:US
Mailing Address - Phone:732-331-3400
Mailing Address - Fax:
Practice Address - Street 1:763 CONVERY BLVD
Practice Address - Street 2:ROUTE 35 SOUTH SUITE L1
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-2525
Practice Address - Country:US
Practice Address - Phone:732-331-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty