Provider Demographics
NPI:1295988616
Name:CARDIOVASCULAR ASSOCIATES, P.A
Entity type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGASH
Authorized Official - Suffix:
Authorized Official - Credentials:M,D,
Authorized Official - Phone:201-794-3256
Mailing Address - Street 1:10-14 SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5728
Mailing Address - Country:US
Mailing Address - Phone:201-794-3256
Mailing Address - Fax:201-794-6457
Practice Address - Street 1:10-14 SADDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-5728
Practice Address - Country:US
Practice Address - Phone:201-794-3256
Practice Address - Fax:201-794-6457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ024765208G00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2670909Medicaid
NJ2670909Medicaid
C60285Medicare UPIN