Healthcare Provider Details

I. General information

NPI: 1295005031
Provider Name (Legal Business Name): TRI-COUNTY CARDIOVASCULAR SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 W RED BANK AVE SUITE 306
WOODBURY NJ
08096-1630
US

IV. Provider business mailing address

509 N BROAD ST
WOODBURY NJ
08096-1617
US

V. Phone/Fax

Practice location:
  • Phone: 856-845-6807
  • Fax: 856-845-3760
Mailing address:
  • Phone: 856-845-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY EDWARD HERMAN
Title or Position: DIRECTOR
Credential: MD
Phone: 856-845-0100