Provider Demographics
NPI:1184732935
Name:BRICK CARDIOVASCULAR SPECIALISTS, P.A.
Entity type:Organization
Organization Name:BRICK CARDIOVASCULAR SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:VITOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-240-3700
Mailing Address - Street 1:147 ROUTE 37 W
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8062
Mailing Address - Country:US
Mailing Address - Phone:732-240-3700
Mailing Address - Fax:732-240-1385
Practice Address - Street 1:147 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8062
Practice Address - Country:US
Practice Address - Phone:732-240-3700
Practice Address - Fax:732-240-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3160408Medicaid
NJ0774979000OtherAMERIHEALTH
NJ2311375OtherAETNA
NJ1073951OtherHORIZON NJ HEALTH
NJCG9694OtherRAILROAD MEDICARE
NJ=========OtherHEALTHNET
NJ=========OtherOXFORD
NJ1073951OtherHORIZON NJ HEALTH
NJ2311375OtherAETNA
NJ=========OtherGHI
NJ=========OtherHORIZON BCBS OF NJ
NJ=========OtherHEALTHNET