Provider Demographics
NPI:1699910778
Name:CARDIOVASCULAR HEALTH ASSOCIATES OF NEW JERSEY, LLC
Entity type:Organization
Organization Name:CARDIOVASCULAR HEALTH ASSOCIATES OF NEW JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERROL
Authorized Official - Middle Name:BALDWIN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:973-239-2323
Mailing Address - Street 1:799 BLOOMFIELD AVE # SITE112
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1367
Mailing Address - Country:US
Mailing Address - Phone:973-239-2323
Mailing Address - Fax:973-239-7556
Practice Address - Street 1:799 BLOOMFIELD AVE # SITE112
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1367
Practice Address - Country:US
Practice Address - Phone:973-239-2323
Practice Address - Fax:973-239-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06621900207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ540910Medicare Oscar/Certification
NJ146169Medicare Oscar/Certification