Provider Demographics
NPI:1912951146
Name:COMPREHENSIVE CARDIOVASCULAR CONSULTANTS LLC
Entity type:Organization
Organization Name:COMPREHENSIVE CARDIOVASCULAR CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:REUTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-292-1020
Mailing Address - Street 1:299 MADISON AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6166
Mailing Address - Country:US
Mailing Address - Phone:973-292-1020
Mailing Address - Fax:973-292-9405
Practice Address - Street 1:299 MADISON AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6166
Practice Address - Country:US
Practice Address - Phone:973-292-1020
Practice Address - Fax:973-292-9405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RC0000X
NJ25MA06404600207RC0000X
NJ25MA06384500207RC0000X
NJ25MA05195400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4677490OtherCIGNA
NJ7582383OtherAETNA HMO
NJ2086491000OtherAMERIHEALTH
NJ2875609OtherAETNA PPO
NJ059498Medicare ID - Type Unspecified
NJ2086491000OtherAMERIHEALTH