Provider Demographics
NPI:1730351164
Name:CARDIOTHORACIC SURGICAL SPECIALIST OF CHERRY HILL P A
Entity type:Organization
Organization Name:CARDIOTHORACIC SURGICAL SPECIALIST OF CHERRY HILL P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRIT
Authorized Official - Middle Name:P
Authorized Official - Last Name:NAYAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-429-7779
Mailing Address - Street 1:705 WORTHINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-4409
Mailing Address - Country:US
Mailing Address - Phone:856-429-7779
Mailing Address - Fax:856-429-7455
Practice Address - Street 1:1245 BRACE RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3214
Practice Address - Country:US
Practice Address - Phone:856-429-7779
Practice Address - Fax:856-429-7455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA406302086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3270904Medicaid
NJ3270904Medicaid