Healthcare Provider Details

I. General information

NPI: 1578650636
Provider Name (Legal Business Name): CARDIOVASCULAR CONSULTING GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MAIN ST SUITE 202
MILLBURN NJ
07041-1367
US

IV. Provider business mailing address

75 MAIN ST SUITE 202
MILLBURN NJ
07041-1367
US

V. Phone/Fax

Practice location:
  • Phone: 888-637-2267
  • Fax: 888-637-2267
Mailing address:
  • Phone: 888-637-2267
  • Fax: 888-637-2267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN P. FARBER
Title or Position: PRESIDENT
Credential: JD, MBA
Phone: 888-637-2267