Provider Demographics
NPI:1861511099
Name:GIOIA CARDIAC AND ENDOVASCULAR INTERVENTIONAL SPECIALTY LLC
Entity type:Organization
Organization Name:GIOIA CARDIAC AND ENDOVASCULAR INTERVENTIONAL SPECIALTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GIUSEPPE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIOIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-926-6900
Mailing Address - Street 1:76 WEST JIMMIE LEEDS ROAD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:POMONA
Mailing Address - State:NJ
Mailing Address - Zip Code:08240
Mailing Address - Country:US
Mailing Address - Phone:609-926-6900
Mailing Address - Fax:609-926-6995
Practice Address - Street 1:76 WEST JIMMIE LEEDS ROAD
Practice Address - Street 2:SUITE 501
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240
Practice Address - Country:US
Practice Address - Phone:609-926-6900
Practice Address - Fax:609-926-6995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RC0000X207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0052981Medicaid
F73381Medicare UPIN