Provider Demographics
NPI:1457548448
Name:CARDIOLOGY ASSOCIATES OF NEW BRUNSWICK, P.A.
Entity type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF NEW BRUNSWICK, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-390-3333
Mailing Address - Street 1:593 CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4029
Mailing Address - Country:US
Mailing Address - Phone:732-390-3333
Mailing Address - Fax:732-257-5432
Practice Address - Street 1:593 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4029
Practice Address - Country:US
Practice Address - Phone:732-390-3333
Practice Address - Fax:732-257-5432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX ID