Provider Demographics
NPI:1063556702
Name:FRANKLIN CARDIOVASCULAR ASSOCIATES PA
Entity type:Organization
Organization Name:FRANKLIN CARDIOVASCULAR ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEPACE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-589-6034
Mailing Address - Street 1:438 GANTTOWN ROAD
Mailing Address - Street 2:SUITES B8-B9
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-1887
Mailing Address - Country:US
Mailing Address - Phone:856-589-6034
Mailing Address - Fax:856-589-6036
Practice Address - Street 1:438 GANTTOWN ROAD
Practice Address - Street 2:SUITES B8-B9
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080
Practice Address - Country:US
Practice Address - Phone:856-589-6034
Practice Address - Fax:856-589-6036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207R00000X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0154010OtherGHI
NJ4100717OtherAETNA
NJ0238889OtherCIGNA
NJ2831271000OtherAMERIHEALTH
NJ60030167OtherHORIZON NEW JERSEY HEALTH
NJ5264006Medicaid
NJ84353OtherAMERIGROUP NEW JERSEY, INC
NJ2831271000OtherINDEPENDENCE BLUE CROSS
NJCL6926OtherRAILROAD MEDICARE
NJ2831271000OtherKEYSTONE
NJ60030167OtherHORIZON NEW JERSEY HEALTH