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General NPI Number Information
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NPI Number | 1699808071
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR IMAGING CONSULTANTS LLC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2070 SPRINGFIELD RD STE 100
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City | CHERRY HILL
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State | NJ
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Zip | 08003
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Country | US
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Telephone | 856-751-7161
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Fax | 856-751-1667
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Provider Business Mailing Address
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Address Line | 2070 SPRINGDALE RD STE 100
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2043
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Country | US
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Telephone | 856-751-7161
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Fax | 856-751-1667
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL MILBOURNE
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Credential | MD
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Telephone | 856-751-7161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 25MA06857100
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License Number State | NJ
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