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General NPI Number Information
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NPI Number | 1124362751
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Entity Type | Organization
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Legal Business Name | ROCHELLE PARK CARDIAC CARE CENTER LLC
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Dates
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Enumeration Date | 11/20/2012
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Last Update Date | 02/22/2013
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Provider Practice Location Address
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Address Line | 186 ROCHELLE AVE
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-4111
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Country | US
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Telephone | 201-501-8500
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Fax | 201-501-8523
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Provider Business Mailing Address
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Address Line | PO BOX 340
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City | NEW MILFORD
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State | NJ
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Zip | 07646-0340
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Country | US
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Telephone | 201-501-8500
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Fax | 201-501-8523
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CONSTANTINE ROSSAKIS
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Credential |
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Telephone | 201-489-3440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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