Provider Demographics
NPI:1912606401
Name:FIRST STATE CARDIOVASCULAR ASSOCIATES INC
Entity Type:Organization
Organization Name:FIRST STATE CARDIOVASCULAR ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:O
Authorized Official - Last Name:EDIAE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-290-6845
Mailing Address - Street 1:750 KINGS HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1772
Mailing Address - Country:US
Mailing Address - Phone:302-200-7530
Mailing Address - Fax:302-200-7966
Practice Address - Street 1:750 KINGS HWY STE 105
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1772
Practice Address - Country:US
Practice Address - Phone:302-200-7530
Practice Address - Fax:302-200-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty