Provider Demographics
NPI:1740239706
Name:CONSULTANTS IN CARDIOLOGY
Entity Type:Organization
Organization Name:CONSULTANTS IN CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CICCONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-467-1544
Mailing Address - Street 1:741 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1174
Mailing Address - Country:US
Mailing Address - Phone:973-467-1544
Mailing Address - Fax:973-530-3554
Practice Address - Street 1:741 NORTHFIELD AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1174
Practice Address - Country:US
Practice Address - Phone:973-467-1544
Practice Address - Fax:973-530-3554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0099908000OtherAMERIHEALTH
NJ2793202Medicaid
NJ7648274OtherAETNA
NJ7648274OtherAETNA