Provider Demographics
NPI:1720251010
Name:CARDIAC ELECTROPHYSIOLOGY, PA
Entity type:Organization
Organization Name:CARDIAC ELECTROPHYSIOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKSENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-302-9988
Mailing Address - Street 1:161 WASHINGTON VALLEY ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-7177
Mailing Address - Country:US
Mailing Address - Phone:732-302-9988
Mailing Address - Fax:732-302-9911
Practice Address - Street 1:161 WASHINGTON VALLEY ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-7177
Practice Address - Country:US
Practice Address - Phone:732-302-9988
Practice Address - Fax:732-302-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03791100207RC0000X
207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8943001Medicaid
NJ8943001Medicaid
NJ061596Medicare PIN
061596Medicare PIN