Provider Demographics
NPI:1205928041
Name:BRUNSWICK CARDIOLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:BRUNSWICK CARDIOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAMINI
Authorized Official - Middle Name:
Authorized Official - Last Name:JEGANATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-246-4699
Mailing Address - Street 1:1140 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3623
Mailing Address - Country:US
Mailing Address - Phone:732-246-4699
Mailing Address - Fax:732-246-4889
Practice Address - Street 1:1140 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3623
Practice Address - Country:US
Practice Address - Phone:732-246-4699
Practice Address - Fax:732-246-4889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
451835Medicare ID - Type Unspecified