Healthcare Provider Details

I. General information

NPI: 1023146784
Provider Name (Legal Business Name): CARDIAC MEDICAL ASSOCIATES, PA.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MAIN STREET
HACKENSACK NJ
07601
US

IV. Provider business mailing address

920 MAIN STREET
HACKENSACK NJ
07601
US

V. Phone/Fax

Practice location:
  • Phone: 201-342-7733
  • Fax: 201-342-7998
Mailing address:
  • Phone: 201-342-7733
  • Fax: 201-342-7998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. MARK DENSON
Title or Position: PRESIDENT
Credential: MD
Phone: 201-342-7733