MEDICARE: CARDIOLOGY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MA08089600	NJ
2	207RC0000X	Cardiovascular Disease Physician	25MA08089600	NJ
3	207RI0011X	Interventional Cardiology Physician	25MA08089600	NJ

General Provider Information

NPI Number	:	1750679148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 202
Second Line	:
City	:	TENAFLY
State	:	NJ
Zip	:	07670-0202
Country	:	US
Telephone Number	:	201-625-2289
Fax Number	:	201-621-0369

Provider Business Practice Location Address
First Line	:	9245 KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5322
Country	:	US
Telephone Number	:	201-567-1703
Fax Number	:	201-621-0369

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN P LIUZZO
Credential	:	MD
Telephone Number	:	201-625-2289

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	08/23/2011

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