Provider Demographics
NPI:1154742872
Name:BERGEN THORACIC AND VASCULAR ASSOCIATES P.C.
Entity type:Organization
Organization Name:BERGEN THORACIC AND VASCULAR ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECTARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-362-0075
Mailing Address - Street 1:5A MEDICAL PARK DRIVE
Mailing Address - Street 2:ROCKLAND THORACIC & VASCULAR ASSOCIATES, P.C.
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970
Mailing Address - Country:US
Mailing Address - Phone:845-362-0075
Mailing Address - Fax:845-362-7475
Practice Address - Street 1:350 ENGLE STREET - 2 EAST (FLOOR)
Practice Address - Street 2:C/O ENGLEWOOD HOSPITAL AND MEDICAL CENTER
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:201-569-1107
Practice Address - Fax:201-569-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty