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General NPI Number Information
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NPI Number | 1790891562
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Entity Type | Organization
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Legal Business Name | GARDEN STATE CARDIO PULMONARY DIAGNOS
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 135 FORT LEE RD SUITE # 201
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City | LEONIA
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State | NJ
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Zip | 07605-2247
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Country | US
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Telephone | 201-592-0777
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Fax | 201-592-0078
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Provider Business Mailing Address
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Address Line | 135 FORT LEE RD SUITE # 201
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City | LEONIA
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State | NJ
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Zip | 07605-2247
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Country | US
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Telephone | 201-592-0777
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Fax | 201-592-0078
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. KOSAR KAZMI
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Credential | RT
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Telephone | 201-592-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | N/A IN NJ AND NY
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License Number State |
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