Healthcare Provider Details

I. General information

NPI: 1679714943
Provider Name (Legal Business Name): CARDIAC IMAGING OF NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 03/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 SOUTH AVE SUITE 104
FANWOOD NJ
07023-1372
US

IV. Provider business mailing address

282 SOUTH AVE SUITE 104
FANWOOD NJ
07023-1372
US

V. Phone/Fax

Practice location:
  • Phone: 908-889-4600
  • Fax: 908-889-5527
Mailing address:
  • Phone: 908-889-4600
  • Fax: 908-889-5527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. MOEIN FAGHIH VASEGHI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 908-889-4600