Provider Demographics
NPI:1780771469
Name:ATLANTIC CARDIOLOGY GROUP, LLP
Entity type:Organization
Organization Name:ATLANTIC CARDIOLOGY GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHIOLENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-543-2288
Mailing Address - Street 1:8 TEMPE WICK RD
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1814
Mailing Address - Country:US
Mailing Address - Phone:973-543-2288
Mailing Address - Fax:973-543-0637
Practice Address - Street 1:8 TEMPE WICK RD
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945
Practice Address - Country:US
Practice Address - Phone:973-543-2288
Practice Address - Fax:973-543-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3286801Medicaid
NJ096018Medicare ID - Type Unspecified