Provider Demographics
NPI:1922066935
Name:CENTRAL JERSEY PULMONARY MEDICINE
Entity Type:Organization
Organization Name:CENTRAL JERSEY PULMONARY MEDICINE
Other - Org Name:CENTRAL JERSEY PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:K
Authorized Official - Last Name:AGGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-264-7755
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:WICKATUNK
Mailing Address - State:NJ
Mailing Address - Zip Code:07765
Mailing Address - Country:US
Mailing Address - Phone:732-264-7755
Mailing Address - Fax:732-264-8858
Practice Address - Street 1:702 N BEERS ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1520
Practice Address - Country:US
Practice Address - Phone:732-264-7755
Practice Address - Fax:732-264-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CH4754OtherRAILROAD MEDICARE
CH4754OtherRAILROAD MEDICARE