Healthcare Provider Details

I. General information

NPI: 1235437534
Provider Name (Legal Business Name): COMPREHENSIVE CARDIAC SERVICES OF NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 BLOOMFIELD AVE SUITE F
BLOOMFIELD NJ
07003-5902
US

IV. Provider business mailing address

135 BLOOMFIELD AVE SUITE F
BLOOMFIELD NJ
07003-5902
US

V. Phone/Fax

Practice location:
  • Phone: 973-707-2916
  • Fax:
Mailing address:
  • Phone: 973-707-2916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: APOSTOLOS VOUDOURIS
Title or Position: OWNER
Credential: MD
Phone: 973-566-6500