Provider Demographics
NPI:1255410890
Name:MARIANO F BATTAGLIA CARDIO VASCULAR SPECIALISTS LLC
Entity type:Organization
Organization Name:MARIANO F BATTAGLIA CARDIO VASCULAR SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANO
Authorized Official - Middle Name:F
Authorized Official - Last Name:BATTAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-205-9515
Mailing Address - Street 1:102 JAMES ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3970
Mailing Address - Country:US
Mailing Address - Phone:732-205-9515
Mailing Address - Fax:732-205-9516
Practice Address - Street 1:102 JAMES ST
Practice Address - Street 2:SUITE 302
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3970
Practice Address - Country:US
Practice Address - Phone:732-205-9515
Practice Address - Fax:732-205-9516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05930400207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5498104Medicaid
NJ899495Medicare ID - Type UnspecifiedMEDICARE ID #
NJE91397Medicare UPIN