Basic Information
| Provider Information | |||||||||
| NPI: | 1841716321 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARDIOEP LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 ALDER LN | ||||||||
| Address2: | |||||||||
| City: | BASKING RIDGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079203708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082349269 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1270 HIGHWAY 35 | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077482014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326153900 | ||||||||
| FaxNumber: | 7326150865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2017 | ||||||||
| LastUpdateDate: | 08/16/2017 | ||||||||
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| AuthorizedOfficialLastName: | DOBRESCU | ||||||||
| AuthorizedOfficialFirstName: | DELIA | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7326153900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0001X | 25MA0853200 | NJ | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | 207RC0000X | 25MA0853200 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.