Healthcare Provider Details

I. General information

NPI: 1275680183
Provider Name (Legal Business Name): CRANBURY HEART & LUNG ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 APPLEGARTH RD
MONROE TWP NJ
08831-3737
US

IV. Provider business mailing address

283 APPLEGARTH RD
MONROE TWP NJ
08831-3737
US

V. Phone/Fax

Practice location:
  • Phone: 609-655-1046
  • Fax: 609-655-3830
Mailing address:
  • Phone: 609-655-1046
  • Fax: 609-655-3830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA04704000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA03545100
License Number StateNJ

VIII. Authorized Official

Name: DR. JAMES NICHOLAS LOGOTHETIS
Title or Position: PRESIDENT
Credential: MD
Phone: 609-655-1046