Healthcare Provider Details

I. General information

NPI: 1053334276
Provider Name (Legal Business Name): HUNTERDON CARDIOVASCULAR ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 03/28/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 STATE ROUTE 31 STE 110
CLINTON NJ
08809-2014
US

IV. Provider business mailing address

1100 WESCOTT DRIVE SUITE G-3
FLEMINGTON NJ
08822
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-0066
  • Fax:
Mailing address:
  • Phone: 908-788-6471
  • Fax: 908-788-6460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GLEN ERIK TONNESSEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 908-788-1710