Provider Demographics
NPI:1366878019
Name:MULKAY CARDIOLOGY CONSULTANTS AT HOLY NAME MEDICAL CENTER, PC
Entity type:Organization
Organization Name:MULKAY CARDIOLOGY CONSULTANTS AT HOLY NAME MEDICAL CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, CMO, EVP
Authorized Official - Prefix:
Authorized Official - First Name:VASANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KONDAMUDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-833-3599
Mailing Address - Street 1:3 UNIVERSITY PLZ STE 205
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:493 ESSEX ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1215
Practice Address - Country:US
Practice Address - Phone:201-996-9244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty