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General NPI Number Information
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NPI Number | 1265962187
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Entity Type | Organization
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Legal Business Name | NJ CARDIOVASCULAR INSTITUTE LLC
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 1265 PATERSON PLANK RD STE 2E
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City | SECAUCUS
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State | NJ
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Zip | 07094
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Country | US
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Telephone | 201-866-7000
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Fax | 201-866-7800
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Provider Business Mailing Address
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Address Line | PO BOX 1405
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City | SECAUCUS
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State | NJ
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Zip | 07096-1405
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Country | US
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Telephone | 973-767-7333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KUNAL MANMOHAN PATEL
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Credential | MD
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Telephone | 973-767-7333
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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 | 25MA09629900
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License Number State | NJ
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