Provider Demographics
NPI:1699585182
Name:THORACIC AND VASCULAR ASSOCIATES OF NEW JERSEY
Entity type:Organization
Organization Name:THORACIC AND VASCULAR ASSOCIATES OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-362-1081
Mailing Address - Street 1:5A MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3516
Mailing Address - Country:US
Mailing Address - Phone:845-362-1081
Mailing Address - Fax:
Practice Address - Street 1:25 ROCKWOOD PL STE 330
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4958
Practice Address - Country:US
Practice Address - Phone:201-408-5195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty