Healthcare Provider Details

I. General information

NPI: 1619262979
Provider Name (Legal Business Name): HUMC CARDIOVASCULAR PARTNERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 CEDAR LN SUITE 208
TEANECK NJ
07666-4314
US

IV. Provider business mailing address

222 CEDAR LN SUITE 208
TEANECK NJ
07666-4314
US

V. Phone/Fax

Practice location:
  • Phone: 201-907-0442
  • Fax: 201-907-0205
Mailing address:
  • Phone: 201-907-0442
  • Fax: 201-907-0205

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: DR. DAVID LANDERS
Title or Position: OWNER
Credential: MD
Phone: 201-907-0442