Healthcare Provider Details

I. General information

NPI: 1316921364
Provider Name (Legal Business Name): CARDIAC IMAGING FOR LIFE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KINDERKAMACK RD SUITE 204
RIVER EDGE NJ
07661-1939
US

IV. Provider business mailing address

401 E 55TH ST
NEW YORK NY
10022-4103
US

V. Phone/Fax

Practice location:
  • Phone: 201-525-1919
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA07209700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA07693000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number25MA07848500
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA07737300
License Number StateNJ

VIII. Authorized Official

Name: RICHARD MUELLER
Title or Position: PRESIDENT
Credential: MD
Phone: 201-525-1919