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General NPI Number Information
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NPI Number | 1497062772
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Entity Type | Organization
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Legal Business Name | CARDIOMD
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 1130 ROUTE 202 BUILDING E
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City | RARITAN
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State | NJ
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Zip | 08869-1490
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Country | US
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Telephone | 908-864-4027
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Fax | 908-864-4029
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Provider Business Mailing Address
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Address Line | 1130 US HIGHWAY 202 BUILDING E
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City | RARITAN
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State | NJ
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Zip | 08869-1490
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Country | US
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Telephone | 908-864-4027
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Fax | 908-864-4029
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHANDRESHWAR N SHAHI
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Credential | MD, FACC
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Telephone | 908-864-4027
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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 | 25MA07079900
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License Number State | NJ
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