Healthcare Provider Details

I. General information

NPI: 1225059660
Provider Name (Legal Business Name): GARDEN STATE CARDIOVASCULAR SPECIALISTS P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 DICKINSON ST
ELIZABETH NJ
07201-2210
US

IV. Provider business mailing address

520 N WOOD AVE
LINDEN NJ
07036-4147
US

V. Phone/Fax

Practice location:
  • Phone: 908-354-8900
  • Fax: 908-354-0007
Mailing address:
  • Phone: 908-587-9300
  • Fax: 908-587-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JASJIT WALIA
Title or Position: MD
Credential:
Phone: 908-587-9300