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General NPI Number Information
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NPI Number | 1699585182
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Entity Type | Organization
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Legal Business Name | THORACIC AND VASCULAR ASSOCIATES OF NEW JERSEY
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 25 ROCKWOOD PL STE 330
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-4958
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Country | US
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Telephone | 201-408-5195
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Fax |
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Provider Business Mailing Address
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Address Line | 5A MEDICAL PARK DR
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City | POMONA
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State | NY
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Zip | 10970-3516
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Country | US
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Telephone | 845-362-1081
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | PATRICIA GERN
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Credential |
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Telephone | 845-362-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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