Provider Demographics
NPI:1891736716
Name:DENVILLE CARDIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:DENVILLE CARDIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:MANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:973-627-2650
Mailing Address - Street 1:16 POCONO ROAD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-627-3217
Mailing Address - Fax:973-627-8383
Practice Address - Street 1:16 POCONO ROAD
Practice Address - Street 2:SUITE 316
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-627-3217
Practice Address - Fax:973-627-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3337707Medicaid
NJ0853300001OtherAMERIHEALTH
NJ91001675200OtherAMERICHOICE
NJ3337707Medicaid