Healthcare Provider Details

I. General information

NPI: 1356372049
Provider Name (Legal Business Name): CARDIOVASCULAR CONSULTANTS OF NORTH JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 TERRACE AVE SUITE 311
HASBROUCK HEIGHTS NJ
07604-3110
US

IV. Provider business mailing address

777 TERRACE AVE SUITE 311
HASBROUCK HEIGHTS NJ
07604-3110
US

V. Phone/Fax

Practice location:
  • Phone: 201-288-4252
  • Fax: 201-288-7172
Mailing address:
  • Phone: 201-288-4252
  • Fax: 201-288-7172

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: MISS ELLEN RIND
Title or Position: OFFICE MANAGER
Credential:
Phone: 201-288-4252