Provider Demographics
NPI:1538227038
Name:PREMIER CARDIOVASCULAR ASSOCIATES, P.C.
Entity type:Organization
Organization Name:PREMIER CARDIOVASCULAR ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNETT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SCHALET
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-898-1220
Mailing Address - Street 1:95 MADISON AVE
Mailing Address - Street 2:SUITE B01
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6023
Mailing Address - Country:US
Mailing Address - Phone:973-898-1220
Mailing Address - Fax:973-898-1496
Practice Address - Street 1:95 MADISON AVE
Practice Address - Street 2:SUITE B01
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6023
Practice Address - Country:US
Practice Address - Phone:973-898-1220
Practice Address - Fax:973-898-1496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8459606Medicaid
NJ8459606Medicaid