Provider Demographics
NPI:1124425772
Name:CARDIO MEDICAL AND VEIN CENTER PC
Entity type:Organization
Organization Name:CARDIO MEDICAL AND VEIN CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PUNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-238-3773
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08871-0007
Mailing Address - Country:US
Mailing Address - Phone:732-238-3773
Mailing Address - Fax:732-238-3622
Practice Address - Street 1:75 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1561
Practice Address - Country:US
Practice Address - Phone:732-238-3773
Practice Address - Fax:732-238-3622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06406800207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7192606Medicaid