Healthcare Provider Details

I. General information

NPI: 1457397549
Provider Name (Legal Business Name): REGIONAL HEART AND LUNG ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 09/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 COURT HOUSE SOUTH DENNIS RD
CAPE MAY COURT HOUSE NJ
08210-1968
US

IV. Provider business mailing address

207 COURT HOUSE SOUTH DENNIS RD
CAPE MAY COURT HOUSE NJ
08210-1968
US

V. Phone/Fax

Practice location:
  • Phone: 609-465-2001
  • Fax: 609-465-8440
Mailing address:
  • Phone: 609-465-2001
  • Fax: 609-465-8440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMB40862
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMB40862
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMB35178
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMB35178
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00120600
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNN08226000
License Number StateNJ

VIII. Authorized Official

Name: DR. MICHAEL BORISS
Title or Position: GENERAL PARTNER
Credential: DO
Phone: 609-465-2001