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General NPI Number Information
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NPI Number | 1669697009
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Entity Type | Organization
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Legal Business Name | GHCP EKG INTERPRETATION PANEL, LLC
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 350 BOULEVARD ST. MARY'S HOSPITAL
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City | PASSAIC
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State | NJ
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Zip | 07055-2840
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Country | US
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Telephone | 201-444-5945
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Fax | 201-444-5947
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Provider Business Mailing Address
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Address Line | PO BOX 450
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City | RIDGEWOOD
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State | NJ
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Zip | 07451-0450
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Country | US
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Telephone | 201-444-5945
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Fax | 201-444-5947
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. DANIEL PATRICK CONROY
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Credential | MD
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Telephone | 201-444-5945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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