Provider Demographics
NPI:1124147657
Name:CLINICAL & INVASIVE CARDIOLOGY
Entity type:Organization
Organization Name:CLINICAL & INVASIVE CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:IX
Authorized Official - Credentials:MD
Authorized Official - Phone:973-751-7322
Mailing Address - Street 1:36 NEWARK AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-4119
Mailing Address - Country:US
Mailing Address - Phone:973-751-7322
Mailing Address - Fax:973-759-3702
Practice Address - Street 1:36 NEWARK AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-4119
Practice Address - Country:US
Practice Address - Phone:973-751-7322
Practice Address - Fax:973-759-3702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06775800363LA2200X
NJMA37311173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3126901Medicaid
NJ527635Medicare ID - Type Unspecified
NJD20028Medicare UPIN