Basic Information
Provider Information
NPI: 1922096478
EntityType: 2
ReplacementNPI:  
OrganizationName: EKG INTERPRETERS OF SALEM COUNTY PA
LastName:  
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Mailing Information
Address1: 2501 OREGON PIKE
Address2: SUITE 101
City: LANCASTER
State: PA
PostalCode: 176014890
CountryCode: US
TelephoneNumber: 7172933223
FaxNumber: 7173902455
Practice Location
Address1: 310 WOODSTOWN RD
Address2:  
City: SALEM
State: NJ
PostalCode: 080792064
CountryCode: US
TelephoneNumber: 8569356700
FaxNumber: 8569356772
Other Information
ProviderEnumerationDate: 10/10/2005
LastUpdateDate: 01/18/2008
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: PARK
AuthorizedOfficialFirstName: STEVEN
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AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8569356700
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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