Healthcare Provider Details

I. General information

NPI: 1518966894
Provider Name (Legal Business Name): MORRISTOWN CARDIOLOGY ASSOC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 SOUTH ST SUITE 5
MORRISTOWN NJ
07960-5377
US

IV. Provider business mailing address

182 SOUTH ST SUITE 5
MORRISTOWN NJ
07960-5377
US

V. Phone/Fax

Practice location:
  • Phone: 973-267-3944
  • Fax: 973-455-0399
Mailing address:
  • Phone: 973-267-3944
  • Fax: 973-455-0399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROBERT MIERZEJEWSKI
Title or Position: ADMINISTRATOR
Credential:
Phone: 973-775-4629