Provider Demographics
NPI:1457397549
Name:REGIONAL HEART AND LUNG ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:REGIONAL HEART AND LUNG ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORISS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-465-2001
Mailing Address - Street 1:207 COURT HOUSE SOUTH DENNIS RD
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-1968
Mailing Address - Country:US
Mailing Address - Phone:609-465-2001
Mailing Address - Fax:609-465-8440
Practice Address - Street 1:207 COURT HOUSE SOUTH DENNIS RD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1968
Practice Address - Country:US
Practice Address - Phone:609-465-2001
Practice Address - Fax:609-465-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB40862207RC0000X, 207RC0200X
NJMB35178207RC0200X, 207RP1001X
NJ26NJ00120600363L00000X
NJNN08226000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3379001Medicaid
NJ534881Medicare ID - Type Unspecified
NJ3379001Medicaid
NJP08215Medicare UPIN
NJE13952Medicare UPIN