Healthcare Provider Details

I. General information

NPI: 1851688667
Provider Name (Legal Business Name): HUMC CARDIOVASCULAR PARTNERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 70TH ST
GUTTENBERG NJ
07093-2417
US

IV. Provider business mailing address

425 70TH ST
GUTTENBERG NJ
07093-2417
US

V. Phone/Fax

Practice location:
  • Phone: 201-854-0055
  • Fax: 201-854-2633
Mailing address:
  • Phone: 201-854-0055
  • Fax: 201-854-2633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSE SANTANA
Title or Position: OWNER
Credential: MD
Phone: 201-854-0055