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General NPI Number Information
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NPI Number | 1467636936
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Entity Type | Organization
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Legal Business Name | CATHEDRAL FACULTY PRACTICE
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 268 DR. MARTIN LUTHER KING BOULEVARD
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City | NEWARK
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State | NJ
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Zip | 07102-2094
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Country | US
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Telephone | 973-877-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 66 W GILBERT ST 2ND FLOOR
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City | RED BANK
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State | NJ
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Zip | 07701-4819
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Country | US
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Telephone | 732-212-0051
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Fax | 732-212-0052
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Authorized Official
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Title or Position | MANAGING PHYSICIAN
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Name | DR. IRVIN GOLDFARB
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Credential | MD
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Telephone | 973-877-5000
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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 | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NJ
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