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General NPI Number Information
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NPI Number | 1366771453
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Entity Type | Organization
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Legal Business Name | FA CV CONSULTANTS PC
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 127 PINE ST STE 1
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4868
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Country | US
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Telephone | 973-744-4075
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Fax | 973-744-2179
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Provider Business Mailing Address
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Address Line | 127 PINE ST STE 1
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4868
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Country | US
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Telephone | 973-744-4075
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Fax | 973-744-2179
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Authorized Official
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Title or Position | CARDIOLOGIST
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Name | DR. FADI AHMED EL-ATAT
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Credential | M.D.
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Telephone | 973-746-1585
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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 | 235356
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA08676700
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License Number State | NJ
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