Provider Demographics
NPI:1104168616
Name:ROCHELLE PARK CARDIAC CENTER CORPORATION
Entity type:Organization
Organization Name:ROCHELLE PARK CARDIAC CENTER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-556-1225
Mailing Address - Street 1:186 ROCHELLE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-4111
Mailing Address - Country:US
Mailing Address - Phone:201-556-1225
Mailing Address - Fax:201-556-1101
Practice Address - Street 1:186 ROCHELLE AVE
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-4111
Practice Address - Country:US
Practice Address - Phone:201-556-1225
Practice Address - Fax:201-556-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty