Provider Demographics
NPI:1023286358
Name:CARDIO CARE ASSOCIATES LLC
Entity type:Organization
Organization Name:CARDIO CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-837-8797
Mailing Address - Street 1:83 SUMMIT AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1262
Mailing Address - Country:US
Mailing Address - Phone:201-488-1320
Mailing Address - Fax:201-488-1596
Practice Address - Street 1:83 SUMMIT AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1262
Practice Address - Country:US
Practice Address - Phone:201-488-1320
Practice Address - Fax:201-488-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ085539Medicare PIN