Provider Demographics
NPI:1841358512
Name:CARDIOLOGY ASSOCIATES
Entity type:Organization
Organization Name:CARDIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-256-5667
Mailing Address - Street 1:999 MCBRIDE AVE
Mailing Address - Street 2:SUITE B204
Mailing Address - City:WEST PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2570
Mailing Address - Country:US
Mailing Address - Phone:973-256-5667
Mailing Address - Fax:973-256-7758
Practice Address - Street 1:999 MCBRIDE AVE
Practice Address - Street 2:SUITE B204
Practice Address - City:WEST PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07424-2570
Practice Address - Country:US
Practice Address - Phone:973-256-5667
Practice Address - Fax:973-256-7758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3102602Medicaid
NJ435451Medicare ID - Type Unspecified