Provider Demographics
NPI:1386977916
Name:PRINCETON CARDIAC AND THORACIC SURGERY ASSOCIATES
Entity type:Organization
Organization Name:PRINCETON CARDIAC AND THORACIC SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:BERRIZBEITIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-430-8484
Mailing Address - Street 1:253 WITHERSPOON ST STE F
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3211
Mailing Address - Country:US
Mailing Address - Phone:609-430-8484
Mailing Address - Fax:
Practice Address - Street 1:253 WITHERSPOON ST STE F
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3211
Practice Address - Country:US
Practice Address - Phone:609-430-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty