Provider Demographics
NPI:1720245541
Name:INTERNAL MEDICINE & CARDIOLOGY LLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE & CARDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-994-2088
Mailing Address - Street 1:340 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4892
Mailing Address - Country:US
Mailing Address - Phone:973-994-2088
Mailing Address - Fax:973-994-1126
Practice Address - Street 1:340 E NORTHFIELD RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4892
Practice Address - Country:US
Practice Address - Phone:973-994-2088
Practice Address - Fax:973-994-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA57985207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5215501Medicaid
NJ086177Medicare PIN
NJF33737Medicare UPIN