Provider Demographics
NPI:1992743595
Name:METROPOLITAN CARDIOVASCULAR
Entity type:Organization
Organization Name:METROPOLITAN CARDIOVASCULAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:V
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-373-1875
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-0068
Mailing Address - Country:US
Mailing Address - Phone:973-373-1875
Mailing Address - Fax:973-373-9005
Practice Address - Street 1:1057 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1946
Practice Address - Country:US
Practice Address - Phone:973-373-1875
Practice Address - Fax:973-373-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA59366174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7291108Medicaid
NJF70932Medicare UPIN
NJ7291108Medicaid