Provider Demographics
NPI:1336277169
Name:CARDIOVASCULAR GROUP-NJ LLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR GROUP-NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:GITTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-521-0150
Mailing Address - Street 1:1 BARTOL AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-2214
Mailing Address - Country:US
Mailing Address - Phone:610-521-0150
Mailing Address - Fax:610-521-6493
Practice Address - Street 1:545 BECKETT RD
Practice Address - Street 2:SUITE 101B
Practice Address - City:LOGAN TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08085-1547
Practice Address - Country:US
Practice Address - Phone:610-521-0150
Practice Address - Fax:610-521-6493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty